Bacterial blood cultures in children with sickle cell disease.

Background: Children with sickle cell disease (SCD) are considered at risk for bacteremia, especially when they present to the emergency department (ED) with fever.

Objective: We aimed to determine the incidence of bacteremia in children with SCD presenting with or without fever to a pediatric ED.

Methods: A retrospective chart review of 692 pediatric ED visits of children with SCD during a 2-year period was conducted.

Measuring tissue oxygen saturation via spectrometer in children.

Background: : Near-infrared spectroscopy is a new noninvasive method of monitoring oxygen saturation at a tissue level. The purpose of this study was to evaluate new near-infrared tissue spectrometer InSpectra (Hutchinson Technology Inc.) in children and to determine preferable areas of the body to measure tissue oxygen saturation (StO2).

Admission and length of stay due to painful vasoocclusive crisis in children.

Purpose: To identify demographic, clinical, and laboratory characteristics associated with admission and a longer length of stay (LOS) due to vasoocclusive crisis (VOC) in children with sickle cell disease (SCD).

Methods: Retrospective chart review at a large tertiary pediatric center. Patients younger than 18 years with VOC due to SCD presenting to the emergency department were included.

Potential vitamin-drug interactions in children: at a pediatric emergency department.

Background: A significant increase in vitamin use has been observed in recent years and interactions between vitamins and medications have been reported.

Objective: To determine the frequency and types of potential interactions between vitamins and medications in children arriving at a large tertiary, pediatric emergency department. We also compared family characteristics of children with potential interactions with those of children with no potential interactions, in order to determine children at a higher risk.

Should weight-loss supplements be used for pediatric obesity?

Question: In my clinic I have a large population of overweight and obese children. There is a range of weight-loss supplements marketed for the adult population. What natural health products for treatment of obesity are effective and can be used in children?

Answer: Weight-loss supplements lack sufficient data supporting their efficacy and safety, even in adults.

Predictors for admission of children with periorbital cellulitis presenting to the pediatric emergency department.

Objectives: To identify demographic and clinical characteristics associated with admission because of periorbital cellulitis (PC) in children.

Methods: Records of children aged 0 to 18 years with PC who visited our tertiary emergency department (ED) in 2004 were reviewed. We calculated a cumulative number of local ocular symptoms in patients that included swelling/edema, redness/erythema, presence of discharge, pain, conjunctival injection, and shut eye.

Potential interactions of drug-natural health products and natural health products-natural health products among children.

Objective: To determine the frequency of concurrent use of conventional medications and natural health products (NHP) and their potential interactions in children arriving at an emergency department.

Study Design: A survey of parents and patients 0 to 18 years at a large pediatric ED in Toronto, Ontario, Canada.

Results: A total of 1804 families were interviewed in this study.

Predictors for opioid analgesia administration in children with abdominal pain presenting to the emergency department.

Objectives: Abdominal pain is one of the most common symptoms in children. The aim of this study was to determine the rate of opioid analgesia in children with abdominal pain presenting to the pediatric Emergency Department (ED) and to identify factors associated with administration of opioids.

Methods: We retrospectively reviewed all charts of patients with abdominal pain < 7 days presenting to the ED of a tertiary pediatric hospital over a 3-month period.

Hypnosis for treatment of pain in children.

Question: Many children suffer from chronic and painful illnesses. Hypnosis was found to be effective for analgesia in adults. Is it effective for managing pain in children?

Answer: Children can be easier to hypnotize than adults.

Prehospital use of analgesics at home or en route to the hospital in children with extremity injuries.

Purpose: The purpose of the study was to document prehospital analgesia (PA) for children with extremity injuries at home or en route to the hospital, as assessed by research personnel at the pediatric emergency department.

Methods: Two parallel groups of patients with fractures or soft-tissue injuries (STIs) were chosen for this prospective observational study. Patients 3 to 18 years of age with a limb or clavicle injury were enrolled.

Physician pain reminder as an intervention to enhance analgesia for extremity and clavicle injuries in pediatric emergency.

Unlabelled: The purpose of this study was to document analgesic use for limb and clavicle injuries in the pediatric emergency department (ED) and to determine whether a physician-oriented pain scale form on the patient's chart would enhance the administration of analgesia. Patients 3 to 18 years old were recruited prospectively in our tertiary pediatric ED in Toronto. The study included 4 crossover periods, 2 with the pain scale form on the patient's chart and 2 without.

Treating infants' colic.

Question: Young parents often visit my office because their infants are crying inconsolably. Results of physical examination are unremarkable, so colic is the most likely cause. Colic has been known for many years, but I am unaware of any good remedy for it.