Bradycardia Without Hypertension: Is It a Common Clinical Presentation of Ventriculoperitoneal Shunt Malfunction in Pediatric Patients?

Background: Mechanical shunting of cerebrospinal fluid is an effective treatment for hydrocephalus. Some studies suggest that bradycardia without hypertension may also be observed in ventriculoperitoneal (VP) shunt malfunction; however, in our experience, this is not a common presenting sign.

Objective: The aim of this study was to evaluate whether bradycardia without hypertension was a common sign in patients presenting to the pediatric emergency department (ED) with a VP shunt malfunction.

Peer-Reviewed Journal Publication of Abstracts Presented at an International Emergency Medicine Scientific Meeting: Outcomes and Comparison With the Previous Meeting.

Scientific presentations at professional organization meetings have long been recognized as a method of providing up-to-date and novel information to both the medical and scientific community. After abstract presentation at a medical conference, the subsequent publication rate of full-text articles is variable, and few studies have examined this topic with respect to international emergency medicine conferences. This study's goals were to determine the publication rate of articles resulting from abstracts presented at the 12th International Conference on Emergency Medicine 2008 in San Francisco, Calif, and to compare this with data from the previous International Conference on Emergency Medicine 2006 conference in Halifax, Nova Scotia, Canada.

The role of physical examination in establishing the diagnosis of pneumonia.

Background: Community-acquired pneumonia (CAP) is an important cause of acute respiratory disease in ambulatory care settings. The objective of this study was to assess the accuracy of medical history and physical examination in diagnosing CAP.

Methods: Pediatric residents prospectively completed a questionnaire documenting patients' medical history and physical examination whenever a chest radiograph was ordered on patients 1 month to 16 years of age.

Unintentional oral beta agonist overdose: case report and review of the literature.

An 18-month-old male infant with oral albuterol intoxication was admitted to our pediatric emergency medicine unit with agitation, moderate hypokalemia (2.36 mEq/L), and hyperglycemia (180 mg/dL). His initial electrocardiogram showed sinus tachycardia with a low-amplitude T waves.

Use of physostigmine for hallucinogenic plant poisoning in a teenager: case report and review of the literature.

The objective of this study was to utilize a case report to review the use of physostigmine for jimsonweed intoxication. A 15-year-old girl was found at school hallucinating and incoherent. Upon presentation to the emergency department, she was found to be tachycardic and confused with dilated pupils and dry, flushed, hot skin.

Pharmacologic treatment of hyperthyroidism during lactation.

Question: I have a patient who has hyperthyroidism due to Graves disease. She was taking methimazole but discontinued when she found out she was pregnant. She is currently close to delivery and might require antithyroid therapy in the postpartum period.

Use of hypoglycemic drugs during lactation.

Question: My patient was taking glipizide (an oral sulfonylurea) for type 2 diabetes. Now she is pregnant and taking insulin instead. She is very anxious to return to her previous treatment immediately after delivery because of the pain and hurdles associated with the administration of insulin.

Methadone exposure during lactation.

Question: One of my patients is currently using methadone for maintenance of opioid dependence. She wants to breastfeed. Is breastfeeding safe for her infant?

Answer: The exposure of infants to methadone through their mothers' breast milk is minimal.