Pulmonary embolism in the pediatric emergency department.

Abstract:

OBJECTIVE:To describe patients who present to the pediatric emergency department (PED) and are subsequently diagnosed with pulmonary embolism (PE). METHODS:Electronic medical records from 2003 to 2011 of a tertiary care pediatric health care system was retrospectively reviewed to identify patients <21 years who had a final International Classification of Diseases, Ninth Revision diagnosis of PE. Patient demographics, and hospital course were recorded. Adult validated clinical decision rules Wells criteria and Pulmonary Embolism Rule-out Criteria (PERC) were retrospectively applied. PERC identified 8 clinical criteria for adult patients using logistic regression modeling to exclude PE without additional diagnostic evaluation. If all criteria are met, further evaluation is not indicated. RESULTS:Of 1 185 794 PED visits, 105 patients had an ultimate diagnosis of PE. Twenty-five met study criteria, and all were admitted. Forty percent of these patients had PE diagnosed in the PED. The most common risk factors were BMI ≥25 (50%, 10 of 20), oral contraceptive use (38% 5 of 13 female patients), and history of previous thrombus without PE (28%, 7 of 25). When the PERC rule was applied retrospectively, 84% of patients could not be ruled out, indicating additional evaluation for PE was needed. CONCLUSIONS:Pulmonary embolism is rare in children but does occur. This study emphasizes risk factors among children that should raise the suspicion of PE. Additional studies are needed to further evaluate risk factors and signs and symptoms of PE to develop pediatric specific clinical decision rules to provide reliable and reproducible means of determining pretest probability of PE.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Agha BS,Sturm JJ,Simon HK,Hirsh DA

doi

10.1542/peds.2013-0126

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

663-7

issue

4

eissn

0031-4005

issn

1098-4275

pii

peds.2013-0126

journal_volume

132

pub_type

杂志文章
  • Regular monitoring of bone age is not useful in children treated with growth hormone.

    abstract::Although bone age estimates are traditionally used to monitor children receiving growth hormone therapy, few data support this practice. Bone age determination is fraught with technical difficulties, resulting in high interobserver differences. Longitudinal studies show that an individual's bone age can change erratic...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Wilson DM

    更新日期:1999-10-01 00:00:00

  • Systematic evidence review of newborn screening and treatment of severe combined immunodeficiency.

    abstract:CONTEXT:Severe combined immunodeficiency (SCID) is a group of disorders that leads to early childhood death as a result of severe infections. Recent research has addressed potential newborn screening for SCID. OBJECTIVE:To conduct a systematic review of the evidence for newborn screening for SCID, including test chara...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2009-1567

    authors: Lipstein EA,Vorono S,Browning MF,Green NS,Kemper AR,Knapp AA,Prosser LA,Perrin JM

    更新日期:2010-05-01 00:00:00

  • Practitioner policies and beliefs and practice immunization rates: a study from Pediatric Research in Office Settings and the National Medical Association.

    abstract:OBJECTIVE:To identify vaccination policies and beliefs associated with practice immunization rates (PIR) among office-based pediatricians. METHODS:Primary care pediatricians recruited from the Pediatric Research in Office Settings (PROS) network of the American Academy of Pediatrics or the Pediatric Section of the Nat...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.109.2.294

    authors: Taylor JA,Darden PM,Brooks DA,Hendricks JW,Baker AE,Wasserman RC

    更新日期:2002-02-01 00:00:00

  • Successful Use of Cidofovir in an Immunocompetent Child With Severe Adenoviral Sepsis.

    abstract::Adenovirus infection is common in childhood and is generally associated with self-limited disease. Cidofovir, a viral DNA polymerase inhibitor, is used to treat adenovirus infection in select populations but is not often recommended for immunocompetent patients because of limited antiviral activity and nephrotoxicity....

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2019-1632

    authors: Alcamo AM,Wolf MS,Alessi LJ,Chong HJ,Green M,Williams JV,Simon DW

    更新日期:2020-01-01 00:00:00

  • The value of brain imaging in children with headaches.

    abstract:OBJECTIVE:To determine the value of performing computed tomography (CT) on magnetic resonance imaging (MRI) studies in children with chronic headaches. BACKGROUND:Headache is a common complaint in children. With the proliferation of brain imaging centers and the increasing patient demand for CT or MRI studies, brain i...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Maytal J,Bienkowski RS,Patel M,Eviatar L

    更新日期:1995-09-01 00:00:00

  • "Greenlight study": a controlled trial of low-literacy, early childhood obesity prevention.

    abstract::Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiven...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2013-3867

    authors: Sanders LM,Perrin EM,Yin HS,Bronaugh A,Rothman RL,Greenlight Study Team.

    更新日期:2014-06-01 00:00:00

  • Studies of the cause and treatment of hyperammonemia in females with ornithine transcarbamylase deficiency.

    abstract::Assay of ornithine transcarbamylase (OTC) activity in multiple small bits of liver (approximately 5 mg) that were obtained from a single surgical biopsy in a patient with OTC deficiency revealed a 10- to 40-fold variation in enzyme activity. Similar studies with control autopsy liver specimens varied 2.5-fold at most....

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Glasgow AM,Kraegel JH,Schulman JD

    更新日期:1978-07-01 00:00:00

  • Cultivating Research Skills During Clinical Training to Promote Pediatric-Scientist Development.

    abstract::Physician-scientists represent a critical component of the biomedical and health research workforce. However, the proportion of physicians who spend a significant amount of effort on scientific research has declined over the past 40 years. This trend has been particularly noticeable in pediatrics despite recent scient...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2019-0745

    authors: Hurst JH,Barrett KJ,Kelly MS,Staples BB,McGann KA,Cunningham CK,Reed AM,Gbadegesin RA,Permar SR

    更新日期:2019-08-01 00:00:00

  • A Quality Improvement Initiative To Improve Postdischarge Antimicrobial Adherence.

    abstract:OBJECTIVES:Bedside delivery of discharge medications improves caregiver understanding and experience. Less is known about its impact on medication adherence. We aimed to improve antimicrobial adherence by increasing on-time first home doses for patients discharged from the pediatric hospital medicine service from 33% t...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2019-2413

    authors: Gupta S,Winckler B,Lopez MA,Costilla M,McCarthy J,Wagner J,Broderick A,French K,Le B,Lo HY

    更新日期:2021-01-01 00:00:00

  • Immunoglobulin subclass antibodies to varicella-zoster virus.

    abstract::Commercially available mouse monoclonal antibodies to human IgG subclass (IgG1 to IgG4) were applied to an enzyme-linked immunosorbent assay to measure IgG subclass-specific antibodies to varicella-zoster virus in children naturally infected with varicella-zoster virus and in varicella vaccine recipients. In children ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Asano Y,Hiroishi Y,Itakura N,Hirose S,Kajita Y,Nagai T,Yazaki T,Takahashi M

    更新日期:1987-12-01 00:00:00

  • Spontaneous Closure of Patent Ductus Arteriosus in Infants ≤1500 g.

    abstract:OBJECTIVES:Patent ductus arteriosus (PDA) remains a challenging issue in very low birth weight (VLBW) infants, and its management varies widely. Our aim in this study was to document the natural course of ductus arteriosus in a cohort of VLBW infants who underwent conservative PDA management with no medical or surgical...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-4258

    authors: Semberova J,Sirc J,Miletin J,Kucera J,Berka I,Sebkova S,O'Sullivan S,Franklin O,Stranak Z

    更新日期:2017-08-01 00:00:00

  • Trends in Access to Health Care Services for US Children: 2000-2014.

    abstract:BACKGROUND AND OBJECTIVE:Recent years have witnessed substantial gains in health insurance coverage for children, but few studies have examined trends across a diverse set of access indicators. We examine US children's access to health services and whether trends vary by race/ethnicity and income. METHODS:Analysis of ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-2176

    authors: Larson K,Cull WL,Racine AD,Olson LM

    更新日期:2016-12-01 00:00:00

  • Comprehensive evaluation of the child with intellectual disability or global developmental delays.

    abstract::Global developmental delay and intellectual disability are relatively common pediatric conditions. This report describes the recommended clinical genetics diagnostic approach. The report is based on a review of published reports, most consisting of medium to large case series of diagnostic tests used, and the proporti...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2014-1839

    authors: Moeschler JB,Shevell M,Committee on Genetics.

    更新日期:2014-09-01 00:00:00

  • Cancer incidence among children and adolescents in the United States, 2001-2003.

    abstract:OBJECTIVE:Our goal was to describe current childhood cancer incidence in the United States and identify demographic and geographic variation among children and adolescents with cancer. METHODS:We examined data from 39 National Program of Cancer Registries and 5 Surveillance, Epidemiology, and End Results statewide reg...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-2964

    authors: Li J,Thompson TD,Miller JW,Pollack LA,Stewart SL

    更新日期:2008-06-01 00:00:00

  • Exemptions From Mandatory Immunization After Legally Mandated Parental Counseling.

    abstract:BACKGROUND:The success of health care provider counseling-based interventions to address vaccine hesitancy is not clear. In 2011, Washington State implemented Senate Bill 5005 (SB5005), requiring counseling and a signed form from a licensed health care provider to obtain an exemption. Evaluating the impact of a counsel...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-2364

    authors: Omer SB,Allen K,Chang DH,Guterman LB,Bednarczyk RA,Jordan A,Buttenheim A,Jones M,Hannan C,deHart MP,Salmon DA

    更新日期:2018-01-01 00:00:00

  • Hyperammonemia associated with perinatal asphyxia.

    abstract::Twelve infants with severe perinatal asphyxia were found to have elevated blood ammonia levels (302 to 960 microgram/100 ml). In the seven survivors, hyperammonemia was associated with CNS irritability, hyperthermia, hypertension, and wide neonatal heart rate oscillations. Follow-up examinations revealed severe neurol...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Goldberg RN,Cabal LA,Sinatra FR,Plajstek CE,Hodgman JE

    更新日期:1979-09-01 00:00:00

  • Emergency Department and Hospital Use Among Adolescents With Justice System Involvement.

    abstract:OBJECTIVES:Adolescents with justice system involvement have high rates of physical and behavioral health disorders and are potentially high users of costly health care services. We examined emergency department (ED) and hospital use among a national sample of adolescents with various levels of justice involvement. MET...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-1144

    authors: Winkelman TNA,Genao I,Wildeman C,Wang EA

    更新日期:2017-11-01 00:00:00

  • Clinical and virologic features of hepatitis C virus infection associated with intravenous immunoglobulin.

    abstract:OBJECTIVE:To characterize the clinical features of hepatitis C virus (HCV) infection associated with the administration of intravenous immunoglobulin (IVIG) in patients with varied immunodeficiencies. DESIGN:Prospective collection of clinical and virologic data in patients determined to have HCV exposure associated wi...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Jonas MM,Baron MJ,Bresee JS,Schneider LC

    更新日期:1996-08-01 00:00:00

  • The Maternal Phenylketonuria Project: a summary of progress and challenges for the future.

    abstract::The results of the International Collaborative Study of Maternal phenylketonuria have shown that dietary phenylalanine restriction of women with hyperphenylalaninemia during pregnancy decreases the incidence of mental retardation, microcephaly, congenital heart disease, and intrauterine growth retardation in their off...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Clarke JT

    更新日期:2003-12-01 00:00:00

  • Exclusive breastfeeding protects against bacterial colonization and day care exposure to otitis media.

    abstract:OBJECTIVE:We followed a cohort (N = 306) of infants at well-baby visits in two suburban pediatric practices to assess the relation of exclusive breastfeeding, and other environmental exposures, to episodes of acute otitis media (AOM) and otitis media with effusion (OME). METHODS:Detailed prospective information about ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.100.4.e7

    authors: Duffy LC,Faden H,Wasielewski R,Wolf J,Krystofik D

    更新日期:1997-10-01 00:00:00

  • Cumulative prevalence of arrest from ages 8 to 23 in a national sample.

    abstract:OBJECTIVE:To estimate the cumulative proportion of youth who self-report having been arrested or taken into custody for illegal or delinquent offenses (excluding arrests for minor traffic violations) from ages 8 to 23 years. METHODS:Self-reported arrest history data (excluding arrests for minor traffic violations) fro...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2010-3710

    authors: Brame R,Turner MG,Paternoster R,Bushway SD

    更新日期:2012-01-01 00:00:00

  • Superior vena cava syndrome in childhood: report of ten cases and review of the literature.

    abstract::Experience with ten children with superior vena cava obstruction is reported. Five patients had non-Hodgkin's lymphoma, two had Hodgkin's disease, two had benign lesions, and one patient was suspected on clinical and radiologic basis to have a lymphoma. The clinical situation at presentation was often critical and req...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Issa PY,Brihi ER,Janin Y,Slim MS

    更新日期:1983-03-01 00:00:00

  • Intentional poisoning of children--an overlooked category of child abuse: report of seven cases and review of the literature.

    abstract::Seven instances of child abuse due to poisoning are reported; two of the children died. Forty-one cases of this form of poisoning are found in the literature. Of the total of 48 children, eight (17%) died as a result of the incident; and one was mentally retarded. The seven different agents described here are alcohol,...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Dine MS,McGovern ME

    更新日期:1982-07-01 00:00:00

  • Exemplar pediatric collaborative improvement networks: achieving results.

    abstract::A number of pediatric collaborative improvement networks have demonstrated improved care and outcomes for children. Regionally, Cincinnati Children's Hospital Medical Center Physician Hospital Organization has sustained key asthma processes, substantially increased the percentage of their asthma population receiving "...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2012-3786F

    authors: Billett AL,Colletti RB,Mandel KE,Miller M,Muething SE,Sharek PJ,Lannon CM

    更新日期:2013-06-01 00:00:00

  • Current pediatrician practices in identifying high-risk behaviors of adolescents.

    abstract:OBJECTIVE:In the United States, 15- to 24-year-olds represent approximately 14% of HIV cases diagnosed in 2006 and almost 50% of the 19 million sexually transmitted infections (STIs) reported annually. This survey assessed pediatricians' practices regarding preventive health care screening, provision of reproductive he...

    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2009-0271

    authors: Henry-Reid LM,O'Connor KG,Klein JD,Cooper E,Flynn P,Futterman DC

    更新日期:2010-04-01 00:00:00

  • Reducing bedtime tantrums: comparison between positive routines and graduated extinction.

    abstract::A total of 36 toddlers and preschool children exhibiting bedtime tantrum activity were randomly assigned to one of three groups: positive routines, graduated extinction, or control. Positive routines involved changing the child's bedtime to coincide with when he naturally fell asleep, as well as parent and child engag...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Adams LA,Rickert VI

    更新日期:1989-11-01 00:00:00

  • Are Patients With Loeys-Dietz Syndrome Misdiagnosed With Beals Syndrome?

    abstract::Beals syndrome, also known as congenital contractural arachnodactyly (Online Mendelian Inheritance in Man: 121050), is an autosomal dominant disorder caused by a mutation in FBN2 that is typically characterized by congenital contractures and arachnodactyly. It shares a number of phenotypic features with Loeys-Dietz sy...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-1281

    authors: Woolnough R,Dhawan A,Dow K,Walia JS

    更新日期:2017-03-01 00:00:00

  • Use of hymenal measurements in the diagnosis of previous penetration.

    abstract:OBJECTIVE:To determine the usefulness of measurements of the vaginal opening and amount of hymenal tissue present inferiorly and laterally in the diagnosis of vaginal penetration. METHODS:The transhymenal diameters and the amount of tissue present between the hymenal edge and vestibule inferiorly at 6 o'clock and late...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.109.2.228

    authors: Berenson AB,Chacko MR,Wiemann CM,Mishaw CO,Friedrich WN,Grady JJ

    更新日期:2002-02-01 00:00:00

  • An evaluation of information-seeking behaviors of general pediatricians.

    abstract:OBJECTIVE:Usage of computer resources at the point of care has a positive effect on physician decision making. Pediatricians' information-seeking behaviors are not well characterized. The goal of this study was to characterize quantitatively the information-seeking behaviors of general pediatricians and specifically co...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章

    doi:10.1542/peds.113.1.64

    authors: D'Alessandro DM,Kreiter CD,Peterson MW

    更新日期:2004-01-01 00:00:00

  • Benign familial macrocephaly: report of a family and review of the literature.

    abstract::Five members in two generations of one family were found to have occipitofrontal head circumferences more than 2 SD above the mean. All five had normal intelligence and neurological examinations. Three of the five had ventricular dilatation by A-mode echoencephalography. The inheritance pattern of macrocephaly in this...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Asch AJ,Myers GJ

    更新日期:1976-04-01 00:00:00