Gastrointestinal Perforation with Blunt Abdominal Trauma in Children.

Gastrointestinal tract perforation is uncommon in children, accounting for <10% of cases of blunt abdominal trauma. Diagnosis of bowel perforation in children can be challenging due to poor diagnostic imaging accuracy. Intra-abdominal free air is found only in half of the children with bowel perforation.

Role of viral pathogen(s) detection in hospital-based management of 29-90-day-old infants with unexplained fever.

Background: The risk for invasive bacterial infection (IBI) in young infants with fever increases the use of invasive and therapeutic interventions, such as lumbar puncture (LP) and antimicrobials which may be unnecessary. In the present study, we analyzed whether viral pathogen(s) detection using a respiratory pathogen panel (RPP) alters the use of LP and antibiotics in 29-90-day-old infants presenting with fever to a regional pediatric hospital.

Methods: We collected medical history, clinical presentation, diagnostic tests and results, treatment, disposition, and length of stay (LOS) for selected patients.

Risk Factors and Outcomes Associated With Antibiotic Therapy in Children Hospitalized With Asthma Exacerbation.

Objective: Despite lack of benefit, antibiotics are overused in management of asthma exacerbation in children. In this study, data from a single children's hospital were analyzed to identify factors and outcomes associated with antibiotic use in children hospitalized with asthma.

Methods: The study population was identified by using administrative data from 2012 to 2015, with subsequent verification of asthma.

The clinical value of procalcitonin cut-off levels for pediatric patients in the hospital setting.

Background: Utilization of procalcitonin (PCT) is challenging for hospital pediatricians because of uncertainty in clinical interpretation. We used a PCT decision cut-off value (<0.15 ng/mL) to identify if PCT can differentiate bacterial infections from viral and other conditions in pediatric patients who presented for hospital-based care.

Combined Effect of Race/Ethnicity and Type of Insurance on Reuse of Urgent Hospital-Based Services in Children Discharged with Asthma.

Asthma is a leading cause of health disparity in children. This study explores the joint effect of race/ethnicity and insurance type on risk for reuse of urgent services within a year of hospitalization. Data were collected from 604 children hospitalized with asthma between 2012 and 2015 and stratified with respect to combination of patients' insurance status (public vs.

Evaluation and analysis of the Modified Finnegan Scoring System for assessment of neonatal abstinence syndrome.

Objective: The Finnegan Neonatal Abstinence Scoring System (FNASS) is the most commonly used scoring system for neonatal abstinence syndrome (NAS) both in its original and modified versions, despite challenges related to tool length and observer bias. The purpose of this study was to determine the most frequent symptoms of NAS that led to score elevation and prompted initiation of drug therapy on the Modified Finnegan (MF). We also sought to identify vital sign changes associated with score elevation.

Does participation in the community outreach for asthma care and healthy lifestyles (COACH) program alter subsequent use of hospital services for children discharged with asthma?

Transition from hospital to home is a challenging time for children with asthma and their caregivers because of the high risk for reutilization of acute hospital services. Detecting effective quality improvement initiatives to reduce utilization of urgent services in children discharged with asthma is an important clinical and public health question. This study was designed to identify the role of a multimodal, nurse-driven, inpatient initiated Community Outreach for Asthma Care and Healthy lifestyles (COACH) program on subsequent use of hospital services for pediatric patients with asthma.

Detection of Acute Gastroenteritis Etiology in Hospitalized Young Children: Associated Factors and Outcomes.

Background: The decision to test for the etiology of diarrhea is a challenging question for practicing pediatricians.

Methods: The main goal of this retrospective cohort study was to identify factors associated with testing for and diagnosis of rotavirus, , or other bacterial infections, as well as the length of stay (LOS) for children with acute gastroenteritis who were hospitalized at a single institution. Patients aged 6 to 60 months with acute diarrhea (<14 days) and no underlying gastrointestinal conditions were included.

Lactobacillus acidophilus Mixture in Treatment of Children Hospitalized With Acute Diarrhea.

Despite unproven effectiveness, Lactobacillus acidophilus is a widely used probiotic in the treatment of pediatric diarrhea. In this report, we evaluated the association between length of stay (LOS) for 290 young children hospitalized with acute diarrhea and adjuvant therapy with a probiotic mixture containing 80% L acidophilus that was included in treatment for 22.4% of them.

Duration of Hospitalization in Association with Type of Inhalation Therapy Used in the Management of Children with Nonsevere, Acute Bronchiolitis.

Background: Acute bronchiolitis is one of the main respiratory emergencies in young children. Although supportive therapy is recommended, substantial inconsistency in the clinical usage of inhaled treatments has been reported. In the present study, we evaluated the association between different types of nebulized therapies in clinical practice and the length of stay (LOS) of young children hospitalized with nonsevere bronchiolitis.

Comparative effectiveness of implementation of a nursing-driven protocol in reducing bronchodilator utilization for hospitalized children with bronchiolitis.

Objective: The goal of our study was to determine whether the administration of bronchodilators is affected by implementation of a nursing-driven protocol in the care of children hospitalized with bronchiolitis.

Methods: We included children less than 2 years old, hospitalized with bronchiolitis, but without chronic lung problems, immunodeficiencies or congenital heart disease in the 1-year periods before, during and after implementation of a nursing-driven bronchiolitis protocol. The protocol is based on nursing assessments of respiratory status prior to initiation and continuation of bronchodilator therapy.

Cocaine-induced dystonic reaction: an unlikely presentation of child neglect.

Child neglect can be difficult to recognize. Parental substance abuse may place a child at increased risk of neglect. This report reviews 2 cases of dystonic reaction in children after accidental exposure to cocaine in their home environments.

Pediatric residents' perceptions of family-centered rounds as part of postgraduate training.

Purpose: Although family-centered rounds (FCRs) are recommended as standard practice, limited data address pediatric residents' opinions of FCRs. In the present study, we assessed residents' perceptions with respect to rounding experience and postgraduate year (PGY).

Methods: An anonymous online questionnaire was distributed to pediatric residents from nine accredited programs in New Jersey.