Abstract:
UNLABELLED:Because late repair of coarctation of the aorta (COA) is associated with premature cardiovascular disease in adult life, early detection and treatment is important. OBJECTIVES:To determine the timing of referral to see whether early detection of COA has improved in the past decade, to evaluate the pattern of and reasons for medical center referral, and to assess the clinical signs relating to the diagnosis of COA. METHODS:The records of 50 consecutive patients older than 1 year who had surgical repair of COA from 1980 to 1990 were reviewed. The age of referral, pattern of referral, and presence of standard clinical signs of COA were analyzed, and data were compared with those from the previous decade. RESULTS:The mean and median ages at referral were 8.4 and 5.8 years, respectively. Pediatricians accounted for 64% of the referrals. A specific diagnosis of COA was made in 2 (4%) of 50 patients before referral to a pediatric cardiologist. The most consistent clinical findings were a cardiac murmur and a systolic blood pressure gradient between the arms and legs of greater than 10 mm Hg, which were both present in all patients. Lower-extremity pulses were decreased in 37 (74%) and absent in 9 (18%). Forty-seven children (94%) had upper-extremity hypertension (> 95th percentile for age); 25 (50%) had systolic blood pressure higher than 140 mm Hg. COA would have been missed in 82% of children if absent lower-extremity pulses were required as a diagnostic feature. These findings were similar to those reported by our institution in the previous decade, suggesting that early detection has not improved. CONCLUSIONS:The timing of, reasons for, and sources of referral for COA in this study, compared with data from the previous decade, indicate no improvement in early detection of COA by pediatricians. Screening all children for COA by routinely measuring upper- and lower-extremity blood pressures during at least one physical examination after the newborn period is mandatory.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Ing FF,Starc TJ,Griffiths SP,Gersony WMsubject
Has Abstractpub_date
1996-09-01 00:00:00pages
378-82issue
3 Pt 1eissn
0031-4005issn
1098-4275journal_volume
98pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::All very low-birth-weight infants live-born to residents of an urban southern Ontario county were studied before (1964 to 1969) and after (1973 to 1977) the introduction of neonatal intensive care. Mortality at hospital discharge decreased from 89.4% to 77.6% among infants whose birth weights were 500 to 999 gm and fr...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1982-05-01 00:00:00
abstract::Localized abscess formation is a rare but previously described manifestation of Haemophilus influenzae infection. A majority of the reported cases were caused by nontypeable strains of H influenzae. We report a case of an extensive subscapular abscess due to beta-lactamase-negative H influenzae type B. This, to our kn...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine alterations in end-of-life support in a multiinstitutional sample of PICUs. METHODS:This was a retrospective, descriptive study. Variables collected included end-of-life support category, race, length of stay, operative status, reason for admission, and Pediatric Index of Mortality...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2010-0420
更新日期:2010-10-01 00:00:00
abstract::The pharmacokinetics of chloramphenicol following intravenous and oral administration were studied in 14 infants with Haemophilus influenzae meningitis. Following five days of treatment with intravenous chloramphenicol (100 mg/kg/day every six hours), oral chloramphenicol was substituted at the same dose. Multiple ser...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::Advances in medical technology have led to dilemmas in initiation and withdrawal of intensive care of newborn infants with a very poor prognosis. Physicians and parents together must make difficult decisions guided by their understanding of the child's best interest. The foundation for these decisions consists of seve...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-3180
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Stillbirth and in-hospital mortality rates associated with very preterm births (VPT) vary widely across Europe. International comparisons are complicated by a lack of standardized data collection and differences in definitions, registration, and reporting. This study aims to determine what prop...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-1990
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this work was to evaluate whether education about zinc supplements and provision of zinc supplements to caregivers is effective in the treatment of acute diarrhea and whether this strategy adversely affects the use of oral rehydration salts. PATIENTS AND METHODS:Six clusters of 30,000 people e...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2007-1939
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:A variety of methods are used to assess the length of infants at hospital admission. A tape-measure technique is commonly used; however, this measure is potentially inaccurate. We aimed to assess accuracy of tape measurement of infant lengths by comparison with the more accurate length-board technique. METHO...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.109.6.1108
更新日期:2002-06-01 00:00:00
abstract::A term female firstborn infant had unexplained nonimmune fetal hydrops and recurrent left chylothorax at 4 weeks of age. A few months before conception, her mother had had acute dystrophic nail changes and is being treated for recurrent sinusitis, bronchiectasis, and a deficiency of serum IgG2. We suggest that they bo...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVES:Although some caregivers are known to premasticate food for infants, usually during the weaning period, HIV transmission has not been linked to this practice. We describe 3 cases of HIV transmission in the United States possibly related to this practice. PATIENTS AND METHODS:Three cases of HIV infection wer...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-3614
更新日期:2009-08-01 00:00:00
abstract::A large neuroblastoma screening study was recently started in the province of Quebec, Canada. This project, a collaboration between the Quebec Network for Genetic Medicine and the University of Minnesota, is studying the impact of screening infants for the preclinical detection of neuroblastoma on the population-based...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Inpatient pediatric mental health is a priority topic for national quality measurement and improvement, but nationally representative data on the patients admitted or their diagnoses are lacking. Our objectives were: to describe pediatric mental health hospitalizations at general medical facil...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-3165
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Emergency department (ED) overcrowding has become a national problem. Children account for nearly 25% of overall ED visits. It has been reported that uninsured and publicly insured children are likely to visit the ED for urgent and nonurgent problems, yet it remains unclear to what extent health insurance st...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.112.2.314
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:Critical congenital heart disease has been proposed as a target of newborn screening. This study aimed to define the incidence and timing of significant physiologic compromise attributable to critical congenital heart disease as well as the distribution of vulnerable lesions. These descriptive parameters must...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-0421
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Gestational age (GA) is frequently unknown or inaccurate in pregnancies in low-income countries. Early identification of preterm infants may help link them to potentially life-saving interventions. METHODS:We conducted a validation study in a community-based birth cohort in rural Bangladesh. GA was determin...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-3303
更新日期:2016-07-01 00:00:00
abstract::L.L. Stephens described several critical issues in medical professionalization. The encounter with morbidity and mortality heightens the student's feelings of vulnerability. If he over-identifies with patients, he may suffer more and be unable to provide rational medical care. If he protects himself by dehumanizing pa...
journal_title:Pediatrics
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract::Ingestion of toxic substances is a common problem in pediatrics. When presented with the limited history of an unknown ingestion in a patient with altered mental status, a clinician depends on the physical examination and a toxic screen to determine the ingested substance(s). Some toxic screens yield false-positive or...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.5.e66
更新日期:2000-05-01 00:00:00
abstract::A 720-g premature newborn developed disseminated candidiasis during treatment with systemic antibiotics and total parenteral nutrition through an umbilical arterial catheter. Clinical features were typical for candidal skeletal infection at this age and included warmth and fusiform swelling of the lower extremities to...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVES:To study the efficacy of otoacoustic emissions (OAEs) as a screening test for hearing impairment in children with acute bacterial meningitis. Hearing tests were performed before discharge from the hospital in an attempt to improve coverage and avoid delays in the diagnosis of postmeningitic hearing loss. ME...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.102.6.1364
更新日期:1998-12-01 00:00:00
abstract::Tobacco use is the leading preventable cause of morbidity and death in the United States. Because 80% to 90% of adult smokers began during adolescence, and two thirds became regular, daily smokers before they reached 19 years of age, tobacco use may be viewed as a pediatric disease. Every year in the United States, ap...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-2121
更新日期:2009-11-01 00:00:00
abstract::Ifosfamide is widely used in the treatment of pediatric solid tumors. Its main adverse effects are various forms of renal tubular and glomerular damage. Many risk factors have been proposed to play a role in the development and severity of nephrotoxicity in children receiving ifosfamide, among which are 1) patient's a...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.101.6.e8
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether risks of impaired cognitive function could be predicted for children or groups of children with adenotonsillar hypertrophy who were suspected of having obstructive sleep-disordered breathing, from historical and polysomnographic variables used separately or i...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-0173
更新日期:2006-09-01 00:00:00
abstract::To determine which warming system more closely approximates a neutral thermal environment, the oxygen consumption of 16 premature babies, weighing less than 1,500 gm each, was measured in a convectively heated incubator and under an open radiant warmer. Both systems were controlled to maintain a skin temperature of 36...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1982-04-01 00:00:00
abstract:OBJECTIVE:To call attention to a cutaneous marker for neural tube closure defects of the scalp, the "hair collar" sign. This finding consists of a ring of long, dark, coarse hair surrounding a midline scalp nodule. METHODS AND RESULTS:Four children with small congenital scalp nodules and the hair collar sign were stud...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract::A 3 6/12-year-old previously healthy girl had intermittent attacks of abdominal pain following a blunt abdominal trauma. At admission to the hospital, she had jaundice and hepatomegaly. Results of laboratory tests indicated an obstructive pattern, and ultrasonography revealed an intraluminal mass in the distal common ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::Agriculture is the second most dangerous occupation in the United States, and unlike other occupations, children make up a significant portion of the work force. This study presents national data on the morbidity and mortality due to farm injuries to children and adolescents less than or equal to 19 years of age. Data...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::There are some children whose parents believe them to be unusually susceptible to medical or developmental problems--"vulnerable"--despite a lack of objective evidence of any difficulty. The "vulnerable child syndrome" refers to a constellation of behaviors that are thought to develop as a result of this excessive par...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract::A full-term male infant delivered by caesarean section following a prolonged rupture of the amniotic membranes of 30 hours' duration manifested peculiar skin lesions at the time of birth consistent with the healing phase of bullous impetigo. He was colonized with beta-hemolytic Streptococcus group B that was also cult...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVES:Rates of overweight have increased dramatically among children in the United States. Although an increase in consumption of food prepared away from home has paralleled overweight trends, few data exist relating food prepared away from home to change in BMI in children. The goals of this study were to (1) exa...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-2732
更新日期:2005-10-01 00:00:00
abstract::Nonfamilial cardiomyopathies in childhood have been only sporadically ascribed to endocrine disorders. We report on a 4-month-old male infant presenting with Cushing's syndrome associated with excessive body weight (8.9 kg; >97th percentile) and features of virilization (Tanner stage 2 for pubic hair development). Abd...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-2692
更新日期:2013-08-01 00:00:00