Abstract:
OBJECTIVES:Obstructive sleep apnea (OSA) and habitual snoring are highly prevalent childhood conditions and have been associated with a large array of negative health outcomes. Although guidelines were published by the American Academy of Pediatrics (AAP) a decade ago recommending routine screening of sleep-disordered breathing (SDB) in primary care settings, it remains unclear to what extent such guidelines have been implemented and resulted in effective SDB screening. The aim of this study was to determine if AAP guidelines are adhered to in pediatric primary care. STUDY DESIGN:In all, 1032 electronic charts of children 4 to 17 years old presenting for well-child visits to 17 pediatricians between January 1 and December 31, 2010, were manually reviewed. Abstracted data included demographic variables and documentation of snoring as well as other sleep-related complaints. RESULTS:The mean age was 8.5 ± 3.9 years (mean ± standard deviation), 49.9% were male, and 79.7% were Hispanic; 24.4% (n = 252) were screened for snoring. Of the children screened for sleep-related issues, 34.1% (n = 86) snored, but the majority of them (61.6%, n = 53) received no further evaluation. In the present sample, 0.5% (n = 5) had a diagnosis of OSA. CONCLUSIONS:The low prevalence of OSA may be explained by the relatively low frequency of sleep-related problem screening by pediatricians and thus the inordinately low adherence to the AAP guidelines. Modification and transition to electronic medical records as well as expanded efforts to educate health care providers and caregivers may improve detection and timely treatment of children at risk for SDB.
journal_name
Clin Pediatr (Phila)journal_title
Clinical pediatricsauthors
Erichsen D,Godoy C,Gränse F,Axelsson J,Rubin D,Gozal Ddoi
10.1177/0009922812464548subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1125-9issue
12eissn
0009-9228issn
1938-2707pii
51/12/1125journal_volume
51pub_type
杂志文章abstract::A descriptive analysis was done on 73 consecutive cases of childhood sexual abuse seen in 1978. There were conspicuous similarities among the cases. Sexually abused children tended to come from households with evidence of family stress. The events occurred in safe havens such as the childrens' own homes, by individual...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288001901007
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abstract::Four children with isolated, persistent elevations of serum transaminases were investigated for hepatic disease and followed for 4 to 24 months before serum creatine kinase determinations were obtained and found to be markedly elevated. Evidence of muscle disease was obtained by close questioning, retrospectively, and...
journal_title:Clinical pediatrics
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abstract::Few studies have described the woman who chooses breast-feeding by more than simple demographics. The purpose of our study was to characterize new mothers by their infant feeding decisions, by demographic and obstetrical data, and by sources of personal support they received during their pregnancies and in making thei...
journal_title:Clinical pediatrics
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doi:10.1177/000992289002900105
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abstract::This study aims to explore the changes in endothelin-1 (ET-1), plasma neuropeptide Y, and calcitonin gene-related peptide (CGRP) in child patients before and after operation. A total of 80 child patients with congenital heart disease (CHD) complicated with pulmonary hypertension (PH) were enrolled and divided into con...
journal_title:Clinical pediatrics
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journal_title:Clinical pediatrics
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abstract::The effects of position (upright vs reclining) and support (held vs chair) on the development and maintenance of feeding behavior were examined in a child with bronchopulmonary dysplasia and gastroesophageal reflux. A reclining position initially facilitated acceptance and swallowing with relatively rapid generalizati...
journal_title:Clinical pediatrics
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abstract::In a patient with suppurative lymphadenitis who fails to respond to antibiotics routinely used for pyogenic adenitis, the diagnosis of tularemia should be considered if there is good evidence for recent tick or other insect exposure. A trial of streptomycin therapy may be indicated, pending culture and serology result...
journal_title:Clinical pediatrics
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journal_title:Clinical pediatrics
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journal_title:Clinical pediatrics
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