Negative Chest Radiography and Risk of Pneumonia.

Abstract:

:: media-1vid110.1542/5804413949001PEDS-VA_2018-0236Video Abstract BACKGROUND AND OBJECTIVES: The ability of the chest radiograph (CXR) to exclude the diagnosis of pneumonia in children is unclear. We sought to determine the negative predictive value of CXR in children with suspected pneumonia. METHODS:Children 3 months to 18 years of age undergoing CXRs for suspected pneumonia in a tertiary-care pediatric emergency department (ED) were prospectively enrolled. Children currently receiving antibiotics and those with underlying chronic medical conditions were excluded. The primary outcome was defined as a physician-ascribed diagnosis of pneumonia independent of radiographic findings. CXR results were classified as positive, equivocal, or negative according to radiologist interpretation. Children with negative CXRs and without a clinical diagnosis of pneumonia were managed for 2 weeks after the ED visit. Children subsequently diagnosed with pneumonia during the follow-up period were considered to have had false-negative CXRs at the ED visit. RESULTS:There were 683 children enrolled during the 2-year study period, with a median age of 3.1 years (interquartile range 1.4-5.9 years). There were 457 children (72.8%) with negative CXRs; 44 of these children (8.9%) were clinically diagnosed with pneumonia, and 42 (9.3%) were given antibiotics for other bacterial syndromes. Of the 411 children with negative CXRs who were managed without antibiotics, 5 were subsequently diagnosed with pneumonia within 2 weeks (negative predictive value of CXR 98.8%; 95% confidence interval 97.0%-99.6%). CONCLUSIONS:A negative CXR excludes pneumonia in the majority of children. Children with negative CXRs and low clinical suspicion for pneumonia can be safely observed without antibiotic therapy.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Lipsett SC,Monuteaux MC,Bachur RG,Finn N,Neuman MI

doi

10.1542/peds.2018-0236

subject

Has Abstract

pub_date

2018-09-01 00:00:00

issue

3

eissn

0031-4005

issn

1098-4275

pii

peds.2018-0236

journal_volume

142

pub_type

杂志文章
  • Intellectual development and familial dysautonomia.

    abstract::The study examined adaptive trends in cognitive development among individuals with familial dysautonomia and sought to establish new base rates of intelligence for the dysautonomic population. Fifty-two subjects, aged 6 to 28 years, were administered the Wechsler scales of intelligence. The results indicate that there...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Welton W,Clayson D,Axelrod FB,Levine DB

    更新日期:1979-05-01 00:00:00

  • Population-based study of the incidence, complexity, and severity of neurologic disability among survivors weighing 500 through 1250 grams at birth: a comparison of two birth cohorts.

    abstract::Mortality and incidence, complexity, and severity of early childhood neurodevelopmental disability are reported for two cohorts of preterm infants of 500 through 1250 g birth weight. Comparing 1978-1979 (cohort 1) and 1988-1989 (cohort 2), 1-year survival improved from 82 (36%) of 226 to 197 (67%) of 291. Cohort 1 sur...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Robertson CM,Hrynchyshyn GJ,Etches PC,Pain KS

    更新日期:1992-11-01 00:00:00

  • Mainstream end-tidal carbon dioxide monitoring in the neonatal intensive care unit.

    abstract:BACKGROUND:Continuous noninvasive monitoring of arterial carbon dioxide (CO2) in neonatal intensive care unit (NICU) patients would help clinicians avoid complications of hypocarbia and hypercarbia. End-tidal CO2 monitoring has not been used in this population to date, but recent technical advances and the introduction...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章

    doi:10.1542/peds.101.4.648

    authors: Rozycki HJ,Sysyn GD,Marshall MK,Malloy R,Wiswell TE

    更新日期:1998-04-01 00:00:00

  • Specialized assessments for children in foster care.

    abstract:OBJECTIVE:To investigate the differences in health problems identified and health services received by children newly entering foster care who participated in a comprehensive multidisciplinary program, compared with children newly entering foster care who received customary community-based services. METHODS:Using a 2-...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.1.59

    authors: Horwitz SM,Owens P,Simms MD

    更新日期:2000-07-01 00:00:00

  • Digital Media and Sleep in Childhood and Adolescence.

    abstract::Given the pervasive use of screen-based media and the high prevalence of insufficient sleep among American youth and teenagers, this brief report summarizes the literature on electronic media and sleep and provides research recommendations. Recent systematic reviews of the literature reveal that the vast majority of s...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2016-1758J

    authors: LeBourgeois MK,Hale L,Chang AM,Akacem LD,Montgomery-Downs HE,Buxton OM

    更新日期:2017-11-01 00:00:00

  • Maternal cigarette smoking and fetal oxygen transport: a study of P50, 2,3-diphosphoglycerate, total hemoglobin, hematocrit, and type F hemoglobin in fetal blood.

    abstract::The current study was undertaken to determine whether the O2 carrying capacity of newborns born to mothers who smoke can accommodate to carbon monoxide poisoning to compensate for the potential tissue hypoxia induced by CO. From a cohort of 1,222 women and newborn infants the total hemogloblin concentration, hematocri...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Bureau MA,Shapcott D,Berthiaume Y,Monette J,Blouin D,Blanchard P,Begin R

    更新日期:1983-07-01 00:00:00

  • Intestinal lesions containing coronavirus-like particles in neonatal necrotizing enterocolitis: an ultrastructural analysis.

    abstract::Since the outbreaks of neonatal necrotizing enterocolitis occurring in maternity hospitals of Paris and suburbs in 1979-1980, it has been possible to examine by light and electron microscopy gut specimens from ten newborns with this illness. Coronavirus-like particles, enclosed in intracytoplasmic vesicles of damaged ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Rousset S,Moscovici O,Lebon P,Barbet JP,Helardot P,Macé B,Bargy F,Le Tan Vinh,Chany C

    更新日期:1984-02-01 00:00:00

  • Biphasic anaphylactic reactions in pediatrics.

    abstract:OBJECTIVES:The objectives of this study were to: 1) determine the incidence of biphasic reactions in children with anaphylaxis; 2) establish what risk factors can predict progression to a biphasic reaction; and 3) assess the utility of inpatient observation for patients whose anaphylaxis appears to have resolved. METH...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.4.762

    authors: Lee JM,Greenes DS

    更新日期:2000-10-01 00:00:00

  • Subacute Neuropsychiatric Syndrome in Girls With SHANK3 Mutations Responds to Immunomodulation.

    abstract::Phenotypic and biological characterization of rare monogenic disorders represents 1 of the most important avenues toward understanding the mechanisms of human disease. Among patients with SH3 and multiple ankyrin repeat domains 3 (SHANK3) mutations, a subset will manifest neurologic regression, psychosis, and mood dis...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2019-1490

    authors: Bey AL,Gorman MP,Gallentine W,Kohlenberg TM,Frankovich J,Jiang YH,Van Haren K

    更新日期:2020-02-01 00:00:00

  • A system for individualized dosing of intravenous aminophylline using a programmable calculator.

    abstract::A program that calculates a value of clearance for an individual patient prior to reaching steady state in the early stages of aminophylline therapy is presented. The program is written for the Texas Instruments TI-59 programmable calculator and may be used with or without the PC-100C printer. The program can provide ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Mitsuoka JC,Fleck RJ

    更新日期:1984-01-01 00:00:00

  • Yield of diagnostic testing in infants who have had an apparent life-threatening event.

    abstract:OBJECTIVE:Many infants who have experienced an apparent life-threatening event (ALTE) seem normal by the time they reach the hospital. Nevertheless, they typically undergo an extensive evaluation to rule out serious underlying conditions. The purpose of the present investigation was to determine the yield of different ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-0847

    authors: Brand DA,Altman RL,Purtill K,Edwards KS

    更新日期:2005-04-01 00:00:00

  • The experience of families with children with trisomy 13 and 18 in social networks.

    abstract:BACKGROUND:Children with trisomy 13 and trisomy 18 (T13-18) have low survival rates and survivors have significant disabilities. For these reasons, interventions are generally not recommended by providers. After a diagnosis, parents may turn to support groups for additional information. METHODS:We surveyed parents of ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2012-0151

    authors: Janvier A,Farlow B,Wilfond BS

    更新日期:2012-08-01 00:00:00

  • Cost-effectiveness analysis of bicycle helmet subsidies in a defined population.

    abstract:OBJECTIVE:To examine the potential effects of bicycle safety helmet cost subsidy on bicycle head injury rates and costs. DESIGN:Using empiric data on the incidence and costs of bicycle injuries to children, we examined the hypothetical effects of various bicycle helmet subsidies in a cost-effectiveness analysis. A hyp...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Thompson RS,Thompson DC,Rivara FP,Salazar AA

    更新日期:1993-05-01 00:00:00

  • Microbiology of the vagina in children: normal and potentially pathogenic organisms.

    abstract::Vaginal cultures from 100 healthy girls, 2 months to 15 years of age, were examined for the presence of normal and potentially pathogenic microorganisms. Corynebacterium vaginale, yeast species, and genital mycoplasmas were isolated from vaginal cultures from 13.5 %, 28%, and 28% of the girls examined, respectively. C...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Hammerschlag MR,Alpert S,Rosner I,Thurston P,Semine D,McComb D,McCormack WM

    更新日期:1978-07-01 00:00:00

  • Phenothiazine-induced sleep apneas in normal infants.

    abstract::A relationship between sudden infant death syndrome and the use of phenothiazine-containing medications is suspected. In order to investigate the influence of phenothiazines upon cardiorespiratory and sleep characteristics, four normal infants (mean age 15.8 weeks) had polygraphic recordings made for one night. The re...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Kahn A,Hasaerts D,Blum D

    更新日期:1985-05-01 00:00:00

  • Improving growth of very low birth weight infants in the first 28 days.

    abstract:OBJECTIVE:To increase weight gain in the first 28 days after birth for very low birth weight (VLBW) infants by isolating and sharing meaningful process differences between high- and low-weight-gain centers within a neonatal network. DESIGN/METHODS:We identified weight gain as an important target for improvement in 199...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.112.1.8

    authors: Bloom BT,Mulligan J,Arnold C,Ellis S,Moffitt S,Rivera A,Kunamneni S,Thomas P,Clark RH,Peabody J

    更新日期:2003-07-01 00:00:00

  • Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.

    abstract:OBJECTIVE:To standardize the use of phototherapy consistent with the American Academy of Pediatrics clinical practice guideline for the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. METHODS:Relevant literature was reviewed. Phototherapy devices currently marketed in the United S...

    journal_title:Pediatrics

    pub_type: 杂志文章,实务指引

    doi:10.1542/peds.2011-1494

    authors: Bhutani VK,Committee on Fetus and Newborn.,American Academy of Pediatrics.

    更新日期:2011-10-01 00:00:00

  • Cerebral oxygenation in preterm infants.

    abstract:BACKGROUND AND OBJECTIVE:Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known ab...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2014-0773

    authors: Fyfe KL,Yiallourou SR,Wong FY,Odoi A,Walker AM,Horne RS

    更新日期:2014-09-01 00:00:00

  • Dating of bruises in children: an assessment of physician accuracy.

    abstract:OBJECTIVE:To determine whether physicians can estimate accurately the age of an accidental bruise on direct physical examination. METHODS:Children who presented to the emergency department of a children's hospital with accidental bruises of known age and origin had demographic data and information about their injury r...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.112.4.804

    authors: Bariciak ED,Plint AC,Gaboury I,Bennett S

    更新日期:2003-10-01 00:00:00

  • Tocopherol efficacy and safety for preventing retinopathy of prematurity: a randomized, controlled, double-masked trial.

    abstract::To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plas...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Phelps DL,Rosenbaum AL,Isenberg SJ,Leake RD,Dorey FJ

    更新日期:1987-04-01 00:00:00

  • Recognition of a Kawasaki disease shock syndrome.

    abstract:OBJECTIVE:We sought to define the characteristics that distinguish Kawasaki disease shock syndrome from hemodynamically normal Kawasaki disease. METHODS:We collected data prospectively for all patients with Kawasaki disease who were treated at a single institution during a 4-year period. We defined Kawasaki disease sh...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2008-1871

    authors: Kanegaye JT,Wilder MS,Molkara D,Frazer JR,Pancheri J,Tremoulet AH,Watson VE,Best BM,Burns JC

    更新日期:2009-05-01 00:00:00

  • Benign rheumatoid nodules.

    abstract::Fifteen asymptomatic children with benign rheumatoid nodules, followed up to 12 years, are described. Nodules are characterized by subcutaneous location with predilection for pretibial regions and scalp, occasional large size, spontaneous regression, and frequent recurrence. Granuloma annulare was present in two patie...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Simons FE,Schaller JG

    更新日期:1975-07-01 00:00:00

  • Birth weight and hearing impairment in norwegians born from 1967 to 1993.

    abstract:OBJECTIVES:To estimate the association between birth weight and hearing impairment among Norwegians born between 1967 and 1993, taking other pregnancy-related conditions into consideration. METHODS:A cohort study was conducted of all Norwegian live births from 1967 to 1993 (n = 1 548 429) linking information of the Me...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.110.3.e30

    authors: Nafstad P,Samuelsen SO,Irgens LM,Bjerkedal T

    更新日期:2002-09-01 00:00:00

  • Duration of poverty and child health in the Quebec Longitudinal Study of Child Development: longitudinal analysis of a birth cohort.

    abstract:OBJECTIVES:The objective of this study was to examine the relationship between duration of poverty and the health of preschool children in the Quebec Longitudinal Study of Child Development birth cohort. METHODS:Data from the Quebec Longitudinal Study of Child Development for 1950 children who were followed annually u...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-1750

    authors: Séguin L,Nikiéma B,Gauvin L,Zunzunegui MV,Xu Q

    更新日期:2007-05-01 00:00:00

  • Human Metapneumovirus Circulation in the United States, 2008 to 2014.

    abstract:BACKGROUND:Human metapneumovirus (HMPV) infection causes respiratory illness, including bronchiolitis and pneumonia. However, national HMPV seasonality, as it compares with respiratory syncytial virus (RSV) and influenza seasonality patterns, has not been well described. METHODS:Hospital and clinical laboratories repo...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2015-2927

    authors: Haynes AK,Fowlkes AL,Schneider E,Mutuc JD,Armstrong GL,Gerber SI

    更新日期:2016-05-01 00:00:00

  • Fatal Haemophilus influenzae endocarditis diagnosed by echocardiography in an infant.

    abstract::A 1-year-old boy was admitted to the hospital with Haemophilus influenzae meningitis. On the second hospital day a heart murmur heard on admission seemed louder. No signs of congestive heart failure were present. An echocardiogram demonstrated a persistent echo-dense mass behind the anterior leaflet of the mitral valv...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Laird WP,Nelson JD,Weinberg AG,Huffines FD

    更新日期:1979-09-01 00:00:00

  • Nonresponse bias in a follow-up study of 19-year-old adolescents born as preterm infants.

    abstract:OBJECTIVE:To assess the effect of demographic and neonatal risk factors and outcome at the last available assessment on the probability of full responders, postal responders (those who only responded to the mailed questionnaire), or nonresponders in a follow-up study of 19-year-old adolescents who were born as preterm ...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.2005-0682

    authors: Hille ET,Elbertse L,Gravenhorst JB,Brand R,Verloove-Vanhorick SP,Dutch POPS-19 Collaborative Study Group.

    更新日期:2005-11-01 00:00:00

  • Computer-Aided Recognition of Facial Attributes for Fetal Alcohol Spectrum Disorders.

    abstract:OBJECTIVES:To compare the detection of facial attributes by computer-based facial recognition software of 2-D images against standard, manual examination in fetal alcohol spectrum disorders (FASD). METHODS:Participants were gathered from the Fetal Alcohol Syndrome Epidemiology Research database. Standard frontal and o...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-2028

    authors: Valentine M,Bihm DCJ,Wolf L,Hoyme HE,May PA,Buckley D,Kalberg W,Abdul-Rahman OA

    更新日期:2017-12-01 00:00:00

  • Special requirements of electronic health record systems in pediatrics.

    abstract::Some functions of an electronic health record system are much more important in providing pediatric care than in adult care. Pediatricians commonly complain about the absence of these "pediatric functions" when they are not available in electronic health record systems. To stimulate electronic health record system ven...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-3527

    authors: Spooner SA,Council on Clinical Information Technology, American Academy of Pediatrics.

    更新日期:2007-03-01 00:00:00

  • High technology for handicapped children: a pediatrician's viewpoint.

    abstract::Children with various types of disabilities are beginning to benefit from the extensive developments in the field of electronic and microcomputer technology that have occurred in recent years. There exists now many devices that can assist children with physical or communication handicaps, learning difficulties, or sen...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Desch LW

    更新日期:1986-01-01 00:00:00