Physician-Specific Utilization of an Electronic Best Practice Alert for Pediatric Sepsis in the Emergency Department.

Background: Early recognition of sepsis remains a critical goal in the pediatric emergency department (ED). Although this has led to the development of best practice alerts (BPAs) to facilitate screening and bundled care, research on how individual physicians interact with sepsis alerts and protocols is limited. This study aims to identify common reasons for acceptance and rejection of a sepsis BPA by pediatric emergency medicine (PEM) physicians and understand how the BPA affects physician management of patients with suspected sepsis.

Updates on pediatric sepsis.

Sepsis, defined as an infection with dysregulated host response leading to life-threatening organ dysfunction, continues to carry a high potential for morbidity and mortality in children. The recognition of sepsis in children in the emergency department (ED) can be challenging, related to the high prevalence of common febrile infections, poor specificity of discriminating features, and the capacity of children to compensate until advanced stages of shock. Sepsis outcomes are strongly dependent on the timeliness of recognition and treatment, which has led to the successful implementation of quality improvement programs, increasing the reliability of sepsis treatment in many US institutions.

Analysis of Missed Sepsis Patients in a Pediatric Emergency Department With a Vital Sign-Based Electronic Sepsis Alert.

Objective: To characterize the cohort of missed sepsis patients since implementation of an electronic sepsis alert in a pediatric emergency department (ED).

Methods: Retrospective cohort study in a tertiary care children's hospital ED from July 1, 2014, to June 30, 2017. Missed patients met international consensus criteria for severe sepsis requiring intensive care unit admission within 24 hours of ED stay but were not treated with the sepsis pathway/order set in the ED.

Symptomatic Persistent Fetal Ovarian Cysts.

Vomiting in young infants is a common presentation to the pediatric emergency department with a broad differential diagnosis. We present 2 cases seen in our emergency department of infant females with symptomatic complex ovarian cysts who presented with vomiting. The first case study describes a patient with a prenatally diagnosed ovarian cyst that was being followed with serial ultrasounds by general surgery.

Six-Year-Old With Altered Mental Status: No "LACk" of Clues.

A previously healthy 6-year-old child presented to our emergency department after a brief seizure associated with hypoglycemia. The differential diagnosis of hypoglycemia can often lead to excessive testing and initiation of unnecessary therapies. It is well-known that alcohol ingestion can lead to hypoglycemia and potentially seizure in children and should be considered in pediatric patients with altered mental status.

A comparison of retinyl palmitate and red palm oil β-carotene as strategies to address Vitamin A deficiency.

Vitamin A deficiency continues to be an international public health problem with several important health consequences including blindness and overall increased rates of morbidity and mortality. To address this widespread issue, a series of strategies have been put into place from dietary diversification to supplementation and fortification programs. Retinyl palmitate has been used successfully for decades as a supplement as well as a way to fortify numerous foods, including vegetable oil, rice, monosodium glutamate, cereal flours and sugar.

Nobel laureates in the history of the vitamins.

Research on vitamins has advanced considerably over the past 100 years with numerous advancements in the fields of biochemistry, medicine, and nutrition. The purpose of this article is to present the history of vitamins using Nobel Prizes as a framework for each vitamin-related discovery. The Nobel Prize Presentation Speech and Nobel Lecture were reviewed for each Nobel Laureate who received an award for vitamin-related research.

Relationship of maternal knowledge of anemia with maternal and child anemia and health-related behaviors targeted at anemia among families in Indonesia.

Our specific aim was to characterize maternal knowledge of anemia and its relationship to maternal and child anemia and to behaviors related to anemia reduction. We examined the relationship between maternal knowledge of anemia and anemia in the mother and the youngest child, aged 6-59 months, in 7,913 families from urban slums and 37,874 families from rural areas of Indonesia. Knowledge of anemia was defined based upon the mother's ability to correctly name at least one symptom of anemia and at least one treatment or strategy for reducing anemia.

Determinants of anemia clustering among mothers and children in Indonesia.

Objectives: To describe risk factors for clustering of anemia among mothers and children in Indonesia.

Methods: An anemia cluster was defined as hemoglobin <12 g/dl in the mother and <11 g/dl in the youngest child, aged 6-59 months.

Results: Anemia clustering occurred in 4907 (18.