Serious Adverse Events Associated with Off-Label Use of Azithromycin or Fentanyl in Children in Intensive Care Units: A Retrospective Chart Review.

Objectives: Half of prescription drugs commonly given to children lack product labeling on pediatric safety, efficacy, and dosing. Two drugs most widely used off-label in pediatrics are azithromycin and fentanyl. We sought to determine the risk of serious adverse events (SAEs) when oral azithromycin or intravenous/intramuscular fentanyl are used off-label compared to on-label in pediatric intensive care units (ICUs).

Use of car beds for infant travel: a review of the literature.

Discharging neonates in a proper car safety seat is standard of care in the United States and many other countries. However, not every neonate can be safely positioned in a standard semi-upright car seat. In these cases, providers may opt for a travel device that allows the infant to lie flat, either supine or prone, known as a car bed.

Clinical Impact of External Laryngeal Manipulation During Laryngoscopy on Tracheal Intubation Success in Critically Ill Children.

Objectives: External laryngeal manipulation is a commonly used maneuver to improve visualization of the glottis during tracheal intubation in children. However, the effectiveness to improve tracheal intubation attempt success rate in the nonanesthesia setting is not clear. The study objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in PICUs.

Pediatric Phalanx Fractures.

Phalangeal fractures are the most common type of hand fracture that occurs in the pediatric population and account for the second highest number of emergency department visits in the United States for fractures. The incidence of phalangeal fractures is the highest in children aged 10 to 14 years, which coincides with the time that most children begin playing contact sports. Younger children are more likely to sustain a phalangeal fracture in the home setting as a result of crush and laceration injuries.

Long-term follow up of ileal pouch anal anastomosis in a large cohort of pediatric and young adult patients with ulcerative colitis.

Aim: The study's aim is to determine long-term outcomes in a large cohort of pediatric and young adult patients who underwent proctocolectomy with ileal pouch anal anastomsis (IPAA) for ulcerative colitis (UC).

Methods: Patients diagnosed with UC in childhood or adolescence (age≤21years) who underwent IPAA in childhood, adolescence, or young adulthood between 1982 and 1997 were contacted to determine pouch history, complications, and quality of life.

Results: Data were obtained from 74 patients out of a previously reported cohort.

Oral Immunotherapy for Food Allergy.

Food allergy is a potentially life-threatening condition with no approved therapies, apart from avoidance and injectable epinephrine for acute allergic reactions. Oral immunotherapy (OIT) is an experimental treatment in which food-allergic patients consume gradually increasing quantities of the food to increase their threshold for allergic reaction. This therapy carries significant risk of allergic reactions.

New Diagnostic Strategies for Detection of Helicobacter pylori Infection in Pediatric Patients.

Helicobacter pylori (H pylori) is a common chronic bacterial infection that is an important cause of peptic ulcer disease and gastroduodenal disease in children. H pylori is also associated with extragastric manifestations, including growth reduction, iron-deficiency anemia, and idiopathic thrombocytopenic purpura. Current guidelines recommend endoscopy with biopsy for the definitive demonstration of H pylori infection.

Emergent diagnostic testing for pediatric nonfebrile seizures.

Background: Guidelines from the American Academy of Neurology recommend laboratory studies or computed tomography (CT) for children who experience a nonfebrile seizure if anything in their history suggests a clinically significant abnormality.

Objective: To ascertain if any patient or seizure characteristics are associated with a greater likelihood that laboratory studies or CT scan will yield clinically significant results.

Methods: This retrospective case series reviewed 93 children with nonfebrile seizure, who were evaluated in an urban pediatric emergency department (ED) between July 2007 and June 2011.

Screening for cardiopulmonary events in neonates: a review of the infant car seat challenge.

The infant car seat challenge (ICSC), or period of observation in a car safety seat before discharge to monitor for episodes of apnea, bradycardia and desaturation, is one of the most common tests performed on preterm neonates in the United States. However, the utility of the ICSC to identify infants at risk for adverse cardiopulmonary events in the car seat remains unclear. Minimal evidence exists to guide clinicians in performance of this test including appropriate inclusion criteria and failure criteria.

Updates in pediatric gastrointestinal foreign bodies.

Although most ingested foreign bodies in children pass spontaneously, certain foreign bodies can be harmful and they require special attention and emergent medical intervention to prevent significant morbidity and mortality. This article presents an overview of the epidemiology, diagnosis, management, and complications of foreign body ingestions in children. Particular attention is paid to coins, sharp objects, long objects, food bolus, caustic liquids, batteries, and magnets.