Abstract:
:An asymptomatic child with a murmur can be challenging practice management conundrum. Some providers refer all patients with a "new" murmur to a cardiologist, likely resulting in excessive resource utilization and parental anxiety. This study examines whether the prevalence of significant cardiac pathology differs in asymptomatic patients aged 2 to 18 years who were referred for a murmur that was "new" versus those referred for a murmur that was known to exist and followed conservatively during the previous 2 years. Of 473 patients meeting inclusion criteria, 33/473 (7.0%) were diagnosed with cardiac pathology, with 21/357 (5.9%) occurring among "new" murmur referrals and 12/116 (10.3%) occurring among "known" murmur referrals. Notably, 34/357 (9.5%) patients referred for a "new" murmur had no murmur present when assessed by the cardiologist. This study suggests that asymptomatic children with a "new" murmur may be conservatively managed. This may lessen health care resource utilization rates and overall parental anxiety.
journal_name
Clin Pediatr (Phila)journal_title
Clinical pediatricsauthors
Gupta LJ,May JWdoi
10.1177/0009922816656623subject
Has Abstractpub_date
2017-04-01 00:00:00pages
357-362issue
4eissn
0009-9228issn
1938-2707pii
0009922816656623journal_volume
56pub_type
杂志文章abstract::Eighty two infants, aged 2-12 months, were prospectively studied for infectious episodes following diphtheria-pertussis-tetanus (DPT) immunization. The occurrence of infectious episodes during the month following vaccination was compared to that during the month prior to its administration. The 3 days following vaccin...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288802701005
更新日期:1988-10-01 00:00:00
abstract::Tests with the Bayley Motor Scale were given to 288 infants, equally divided by sex, in Yucatan, Mexico. These were 2 to 54 weeks in age and came from three sociocultural levels. In comparison to USA infants, early acceleration of motor development was followed by a marked downward trend. This phenomenon, if observed ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992287801701106
更新日期:1978-11-01 00:00:00
abstract::Childhood thyrotoxicosis is not an uncommon illness, but there is a considerable relapse rate in these patients on medical treatment. An attempt is made in this study to identify those markers that are predictive of a tendency to relapse in childhood thyrotoxicosis. A total of 32 patients with Graves disease were incl...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288702600306
更新日期:1987-03-01 00:00:00
abstract::Two infants presented with growth failure and were found to have generalized osteomalacia (rickets) due to phosphate depletion from prolonged administration of an aluminum-containing antacid given for the symptoms of colic. One of the infants developed bilateral proptosis due to craniosynostosis related to the underly...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289503400202
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Control of environmental triggers (ETs) greatly improves asthma outcomes in children. Disseminating these findings to general pediatricians has not been well established. METHODS:After delivering a structured and standardized presentation on ET identification and control to pediatricians, we surveyed them a...
journal_title:Clinical pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1177/0009922813482752
更新日期:2013-06-01 00:00:00
abstract::This study was conducted to determine whether intravenous theophylline, added to inhaled albuterol and intravenous methylprednisolone, provides a clinically significant benefit in the treatment of pediatric status asthmaticus. Patients aged 2 to 10 years were randomized to receive either intravenous theophylline or pl...
journal_title:Clinical pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/000992289503400905
更新日期:1995-09-01 00:00:00
abstract::Two types of calipers to measure skinfolds have been compared in adults, but the same type of comparison has not been done in a pediatric population who generally would have smaller skinfolds. Biceps and triceps skinfold measurements were made in 240 pediatric patients ranging in age from 2 weeks to 18 years. Skinfold...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288402300104
更新日期:1984-01-01 00:00:00
abstract::Two children with multiple severe disabilities due to brain destruction by neonatal infection had recurrent hypothermia (less than 34 degrees C) with associated thrombocytopenia (less than 50,000), and clinical hemorrhage. They also had milder, less consistent erythroid and myeloid cell line abnormalities. The hypothe...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288802700703
更新日期:1988-07-01 00:00:00
abstract::Henoch-Schönlein purpura (HSP) is the most common vasculitis occurring in childhood. Clinical presentation involves the classic tetrad of abdominal pain, nonthrombocytopenic purpura, arthritis, and renal involvement. Dermatological manifestations of HSP are characteristic of the condition and consist of palpable purpu...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922810374977
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:In the future, surgical management of pediatric appendicitis might become limited to nonperforating appendicitis. Thus, it becomes increasingly important to differentiate advanced from simple appendicitis and to predict perforated appendicitis among a group of children with right-sided abdominal pain, which ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922816678976
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Acid-suppressing agents have been associated with increased Clostridium difficile infection (CDI) in adults. The objective of this study was to evaluate the association of acid-suppressing therapy with the development of CDI in the pediatric population. METHODS:This was a retrospective case-control study. C...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922815569201
更新日期:2015-10-01 00:00:00
abstract::Acute pancreatitis is unusual in pediatric patients, and chronic pancreatitis is even less common. Between 1983 and 1988, we diagnosed 24 patients in late childhood and adolescence with chronic pancreatitis. Our review revealed that chronic pancreatitis presents as recurrent abdominal pain in late childhood and adoles...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289403300205
更新日期:1994-02-01 00:00:00
abstract::The paper presents clinical manifestations and results of cytogenetic examination of two patients with trisomy 8 mosaicism syndrome. The findings confirm the extreme phenotype variability of this syndrome. Both the first patient, a mentally retarded child with multiple dysmorphic changes, and the second, a 31-year-old...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288802701109
更新日期:1988-11-01 00:00:00
abstract::Emergency physicians need to clinically differentiate children with and without radiographic evidence of pneumonia. In this prospective cohort study of 510 patients 2 to 59 months of age presenting with symptoms of lower respiratory tract infection, 100% were evaluated with chest radiography and 44 (8.6%) had pneumoni...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280504400508
更新日期:2005-06-01 00:00:00
abstract::When evaluating a school-aged patient, particularly for such issues as attention deficit disorder, or learning disabilities, health-care providers are encouraged to appraise children's school performance. Although some clinicians seek teachers' comments, recent research suggests that teachers' appraisals have limited ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280204100909
更新日期:2002-11-01 00:00:00
abstract::The Vaccines for Children (VFC) program distributes one half of all vaccines administered to US children. Compared with commercial vaccine distribution, VFC distribution is more complex. This prospective observational study compares the delivery and administration of VFC versus non-VFC influenza vaccine in US pediatri...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922812470868
更新日期:2013-03-01 00:00:00
abstract::With discouragingly low vaccination rates for human papillomavirus (HPV), we sought to improve the HPV vaccine completion rate for adolescents by increasing the consistency and quality of provider recommendations. Baseline data was extracted for vaccine completion rates among patients aged 13 to 17 years. Quality impr...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922817722014
更新日期:2018-03-01 00:00:00
abstract::Antibiotic choice for pediatric community-acquired pneumonia (CAP) varies widely. We aimed to determine the impact of a 6-month personalized audit and feedback program on primary care providers' antibiotic prescribing practices for CAP. Participants in the intervention group received monthly personalized feedback. We ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922820928054
更新日期:2020-10-01 00:00:00
abstract::Using questionnaires, administrative claims, and chart review data, the current study explored the impact of using an electronic medical record system to administer, score, and store the Pediatric Symptom Checklist (PSC-17) during annual pediatric well-child visits. Within a sample of 1773 Medicaid-insured outpatients...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922819892038
更新日期:2020-02-01 00:00:00
abstract::To describe pediatric clinicians' adherence to practice recommendations for obesity prevention and treatment, we conducted a cross-sectional analysis of 227 medical records of 3- to 18-year-old patients (seen from September 2003 to April 2004) and a longitudinal analysis of data from 632 overweight and obese patients ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922809346567
更新日期:2010-02-01 00:00:00
abstract::Pediatricians are expected to discuss the hazards of passive smoking and provide smoking cessation counseling (SCC) because passive smoking is known to have a direct negative effect on children's health. We conducted a cross-sectional survey of pediatric and medicine- pediatric residents at 2 training programs to iden...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922807308182
更新日期:2008-04-01 00:00:00
abstract::State regulations for neonatal screening for metabolic diseases do not optimally serve the needs of the dependents of the U.S. Armed Forces. Guidelines are therefore proposed for the neonatal screening for metabolic disease based both on responses received across the United States and on the unique needs of the U.S. A...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288702600705
更新日期:1987-07-01 00:00:00
abstract::Scleredema is a rare connective disease which must be differentiated from scleroderma in childhood. Scleredema is characterized by thickening of the dermis of the neck, head, and upper trunk. We report a case of scleredema in an 8-year-old boy with coincident streptococcal colonization. The patient report demonstrates...
journal_title:Clinical pediatrics
pub_type: 杂志文章,评审
doi:10.1177/000992289403301006
更新日期:1994-10-01 00:00:00
abstract::The authors compared dipstick tests for leukocyte esterase and nitrite and microscopic examination of urinary sediment with urine culture to assess whether the former tests could reliably rule out bacteriuria in specimens from children. The authors studied urine specimens from 1010 infants and children younger than ag...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289002900402
更新日期:1990-04-01 00:00:00
abstract::Seroprevalence of hepatitis B virus markers was examined in employees participating in patient care at The Children's Mercy Hospital in Kansas City, Missouri. Of 377 workers tested in 1985-86, 36 (9.6%) were seropositive for any marker. Among 285 employees who presumably have only work-related hepatitis B exposure, 14...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288902800601
更新日期:1989-06-01 00:00:00
abstract::We reviewed 74 outpatient febrile episodes in 22 pediatric heart transplant patients in order to determine etiologies, rates of serious and nonserious illness, and factors predictive of serious disease. Twenty-two febrile episodes (30%) resulted in hospital admission. Only three variables were predictive of serious il...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289603500902
更新日期:1996-09-01 00:00:00
abstract::The aim of this study was to determine the French norms and examine the validity of a parent-report inventory: the Child Development Inventory (CDI), called "Inventaire du Développement de l'Enfant (IDE)" in French. This assesses the general level of a child's development in 8 developmental domains. The norms were det...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922811398390
更新日期:2011-07-01 00:00:00
abstract::The relationship between lipids, lipoproteins, total homocysteine, and lipoprotein (a) was studied in hypercholesterolemic and normocholesterolemic children. In hypercholesterolemic children, concentrations of total cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B, and triglycerides were signif...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280104000304
更新日期:2001-03-01 00:00:00
abstract::Central nervous system (CNS) complications of hemolytic-uremic syndrome (HUS) commonly consist of alterations in mental status, seizures, and rarely hemiparesis. The authors report the clinical evolution of left hemiparesis and later choreo-athetoid movements in a patient who sustained a right lacunar infarction as a ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288702601106
更新日期:1987-11-01 00:00:00
abstract::According to the National Health and Nutrition Examination Survey in 2007, nearly half of all American children are either overweight or obese. Retrospective chart review identified patients with the diagnostic codes for overweight, obese, and/or excessive weight gain. Inclusion criteria were current age between 2 and...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922809359418
更新日期:2010-07-01 00:00:00