Risk stratification of children being evaluated for intussusception.

Abstract:

CONTEXT:Intussusception is the most common cause of intestinal obstruction in young children, and delayed diagnosis may lead to bowel perforation. OBJECTIVE:To determine predictive clinical criteria and develop a decision tree to risk-stratify children with possible intussusception. DESIGN/METHODS:This is a prospective observational cohort study of children aged 1 month to 6 years who presented with possible intussusception. A data-collection form was completed before knowledge of any advanced imaging. Univariate analysis was performed, and decision trees were developed using recursive partitioning. RESULTS:In the study, 310 patients were enrolled, including 38 (12.3%) with intussusception. The median age was 21.1 months and 61% were male. Univariate predictors of intussusception included age older than 6 months (P = 0.04), male gender (P = .007), history of lethargy (P = .001), and abnormal plain x-ray (P = .0001). Multivariate analysis through recursive partitioning identified decision trees (with and without the result of a plain abdominal x-ray) and allowed identification of patients at low risk. The decision tree based on the results of an abdominal x-ray (negative or positive), age (≤ 5 or >5 months), diarrhea (present or absent), and bilious emesis (present or absent) had the best test performance (sensitivity: 97% [95% confidence interval (CI): 86-100]; negative predictive value: 99% [95% CI: 93-100]; negative likelihood ratio: 0.08 [95% CI: 0.01-0.6]). CONCLUSIONS:Among children who were being evaluated for intussusception, we prospectively determined clinical criteria and developed a decision tree to risk-stratify children with possible intussusception.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Weihmiller SN,Buonomo C,Bachur R

doi

10.1542/peds.2010-2432

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

e296-303

issue

2

eissn

0031-4005

issn

1098-4275

pii

peds.2010-2432

journal_volume

127

pub_type

杂志文章
  • Educational principles of community-based education.

    abstract::Much of medical education remains teacher centered, as exemplified by the continued emphasis on lectures. Increasingly, however, the importance of the learner is being recognized and acknowledged in medical school curricula. The distinction between teaching and learning is also an issue for graduate medical education;...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Roberts KB

    更新日期:1996-12-01 00:00:00

  • Randomized trial of a cellular phone-enhanced home visitation parenting intervention.

    abstract:BACKGROUND AND OBJECTIVES:Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to exami...

    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2013-1021Q

    authors: Carta JJ,Lefever JB,Bigelow K,Borkowski J,Warren SF

    更新日期:2013-11-01 00:00:00

  • Palivizumab, a Humanized Respiratory Syncytial Virus Monoclonal Antibody, Reduces Hospitalization From Respiratory Syncytial Virus Infection in High-risk Infants.

    abstract::Objective. To determine the safety and efficacy of prophylaxis with palivizumab in reducing the incidence of hospitalization because of respiratory syncytial virus (RSV) infection in high-risk infants. Methods. A randomized, double-blind, placebo-controlled trial was conducted at 139 centers in the United States, the ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors:

    更新日期:1998-09-01 00:00:00

  • Ophthalmia neonatorum: a chart review.

    abstract::Cases of ophthalmia neonatorum diagnosed at Grady Memorial Hospital 1967-1973 were reviewed. Of 302 cases 43 could be diagnosed as gonococcal, 86 chlamydial, 3 gonococcal and chlamydial, 31 staphylococcal, and 5 chemical. Silver nitrate prophylaxis was routinely employed. Gonococcal cases peaked during the third quart...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Armstrong JH,Zacarias F,Rein MF

    更新日期:1976-06-01 00:00:00

  • Obesity at the onset of diabetes in an ethnically diverse population of children: what does it mean for epidemiologists and clinicians?

    abstract:OBJECTIVE:It is often difficult to determine the pathophysiology of childhood diabetes at onset, particularly in overweight children, because obesity has been associated with both type 1 and type 2 diabetes. We compared children at the diagnosis of diabetes in a multiethnic population-based registry to understand the e...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-1448

    authors: Lipton RB,Drum M,Burnet D,Rich B,Cooper A,Baumann E,Hagopian W

    更新日期:2005-05-01 00:00:00

  • Please Test My Child for a Cancer Gene, but Don't Tell Her.

    abstract::A 38-year-old woman is diagnosed with Li-Fraumeni syndrome, an autosomal dominant genetic condition that predisposes to a variety of cancers. The woman has an 11-year-old daughter. The geneticist recommends that the child be tested for the Li-Fraumeni genetic variant. The mother is concerned about the impact of testin...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-2238

    authors: Bester J,Sabatello M,van Karnebeek CDM,Lantos JD

    更新日期:2018-04-01 00:00:00

  • Treatment of apnea of prematurity with aminophylline.

    abstract::The effectiveness of aminophylline in the treatment of apnea of prematurity was evaluated in 13 premature infants (mean birthweight, 1.13 kg; mean gestational age, 29 weeks). Apnea was recorded by direct observation in combination with impedance monitoring. Rectal suppositories of aminophylline (5 mg) were given at si...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Bednarek FJ,Roloff DW

    更新日期:1976-09-01 00:00:00

  • Effects of the accreditation council for graduate medical education duty hour limits on sleep, work hours, and safety.

    abstract:OBJECTIVE:To mitigate the risks of fatigue-related medical errors, the Accreditation Council for Graduate Medical Education introduced work hour limits for resident physicians in 2003. Our goal was to determine whether work hours, sleep, and safety changed after implementation of the Accreditation Council for Graduate ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-2306

    authors: Landrigan CP,Fahrenkopf AM,Lewin D,Sharek PJ,Barger LK,Eisner M,Edwards S,Chiang VW,Wiedermann BL,Sectish TC

    更新日期:2008-08-01 00:00:00

  • Plasma creatinine rises dramatically in the first 48 hours of life in preterm infants.

    abstract:OBJECTIVE:Published data show that plasma creatinine falls steadily during the first 28 days of life and that creatinine levels in the neonatal period are higher in more premature infants. However, the best reference data commence on day 2 of life. The objective of this study was to document how plasma creatinine chang...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.104.6.e76

    authors: Miall LS,Henderson MJ,Turner AJ,Brownlee KG,Brocklebank JT,Newell SJ,Allgar VL

    更新日期:1999-12-01 00:00:00

  • Effects of therapeutic irradiation delivered in early childhood upon subsequent lung function.

    abstract::To determine the long-term effects of therapeutic pulmonary irradiation and treatment with actinomycin D during a period of lung growth, 12 patients treated for Wilms' tumor metastatic to the lung and 8 patients treated for Wilms' tumor with no evidence of pulmonary metastases were studied 7 to 14 years after their in...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Wohl ME,Griscom NT,Traggis DG,Jaffe N

    更新日期:1975-04-01 00:00:00

  • Prevalence and impact of respiratory viral infections in young children with cystic fibrosis: prospective cohort study.

    abstract:OBJECTIVE:We aimed to investigate differences in upper and lower respiratory tract symptoms in relation to respiratory viral infections detected with polymerase chain reaction assays in young children with cystic fibrosis and healthy control subjects. METHODS:In a 6-month winter period, 20 young children with cystic f...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-3139

    authors: van Ewijk BE,van der Zalm MM,Wolfs TF,Fleer A,Kimpen JL,Wilbrink B,van der Ent CK

    更新日期:2008-12-01 00:00:00

  • Initial neurologic presentation in young children sustaining inflicted and unintentional fatal head injuries.

    abstract:BACKGROUND:It remains unclear if fatal brain injuries in young children are characterized by immediate rapid deterioration or can present after an initial period of lucidity. This issue has legal implications in child abuse, for which understanding the clinical course affects perpetrator identification. OBJECTIVE:To d...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-2671

    authors: Arbogast KB,Margulies SS,Christian CW

    更新日期:2005-07-01 00:00:00

  • Placental features in preterm infants with periventricular leukomalacia.

    abstract:OBJECTIVE:Evaluation of the placenta provides some important insights into pathophysiologic changes that take place during the prenatal and intrapartum process. We investigated the relationship between placental findings and periventricular leukomalacia (PVL) to obtain a better understanding of its cause. METHODS:Thir...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.109.4.650

    authors: Kumazaki K,Nakayama M,Sumida Y,Ozono K,Mushiake S,Suehara N,Wada Y,Fujimura M

    更新日期:2002-04-01 00:00:00

  • Pacifier use and morbidity in the first six months of life.

    abstract:OBJECTIVE:To assess the prevalence of pacifier use and whether this habit adversely affects the health of 6-month-old infants. DESIGN:Data collected via self-completion questionnaires from mothers forming part of the prospective, population-based Avon Longitudinal Study of Pregnancy and Childhood. METHODS:The mothers...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.103.3.e34

    authors: North K,Fleming P,Golding J

    更新日期:1999-03-01 00:00:00

  • A 17-Year-Old With Chest Pain.

    abstract::A 17-year-old male subject with a history of deep venous thrombosis presented with acute unilateral severe chest pain. His examination was nonspecific, and vital signs were normal. His initial laboratory evaluation revealed mild thrombocytopenia, elevated troponin levels, and critically elevated activated partial thro...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2016-0794

    authors: Shah AY,Jamison M,Otero HJ,Jung L,Frank LH,Guerrera MF,Kirkorian AY

    更新日期:2017-03-01 00:00:00

  • Successful Chest Radiograph Reduction by Using Quality Improvement Methodology for Children With Asthma.

    abstract:OBJECTIVES:Implementation of an asthma clinical practice guideline did not achieve desired chest radiograph (CXR) usage goals. We attempt to use quality improvement methodology to decrease the percentage of CXRs obtained for pediatric patients with acute asthma exacerbations from 29.3% to <20% and to evaluate whether d...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-4003

    authors: Watnick CS,Arnold DH,Latuska R,O'Connor M,Johnson DP

    更新日期:2018-08-01 00:00:00

  • Adolescent vaccine co-administration and coverage in New York City: 2007-2013.

    abstract:OBJECTIVES:To investigate adolescent vaccination in New York City, we assessed tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal conjugate (MCV4), and human papillomavirus (HPV) vaccine uptake, vaccine co-administration, and catch-up coverage over time. METHODS:We analyzed data from the Citywide Immun...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2014-1452

    authors: Sull M,Eavey J,Papadouka V,Mandell R,Hansen MA,Zucker JR

    更新日期:2014-12-01 00:00:00

  • Association of H2-blocker therapy and higher incidence of necrotizing enterocolitis in very low birth weight infants.

    abstract:OBJECTIVE:We sought to determine if an association exists between the use of histamine-2 receptor (H2) blockers and the incidence of necrotizing enterocolitis (NEC) in infants of 401 to 1500 g in birth weight. STUDY DESIGN:Data from the National Institute of Child Health and Human Development Neonatal Research Network...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2005-1543

    authors: Guillet R,Stoll BJ,Cotten CM,Gantz M,McDonald S,Poole WK,Phelps DL,National Institute of Child Health and Human Development Neonatal Research Network.

    更新日期:2006-02-01 00:00:00

  • Contraception in the adolescent: current concepts for the pediatrician.

    abstract::An overview is presented of the major methods of contraception available to the sexually active adolescent. Emphasis is given to the combined birth control pill, while the literature describing absolute and relative contraindications to oral contraception is reviewed. It is noted that adolescents with chronic illness ...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:

    authors: Greydanus DE,McAnarney ER

    更新日期:1980-01-01 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

  • 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 mont...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2018-0236

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

    更新日期:2018-09-01 00:00:00

  • Management of pituitary-adrenal suppression secondary to corticosteroid therapy.

    abstract::Withdrawal of steroid medications from patients who have been receiving them for management of chronic disease carries the risk of certain serious complications. An understanding of adrenal physiology, coupled with a rational plan for evaluating the individual patient, when necessary, and for protecting against certai...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Chamberlin P,Meyer WJ 3rd

    更新日期:1981-02-01 00:00:00

  • Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study.

    abstract:OBJECTIVES:To evaluate the role of primary vesicoureteral reflux (VUR) in increasing the frequency and severity of urinary tract infections (UTIs) and renal parenchymal damage among patients with acute pyelonephritis and to determine whether urinary antibiotic prophylaxis reduces the frequency and/or severity of UTIs a...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2005-1362

    authors: Garin EH,Olavarria F,Garcia Nieto V,Valenciano B,Campos A,Young L

    更新日期:2006-03-01 00:00:00

  • The Family Perspective on Hospital to Home Transitions: A Qualitative Study.

    abstract:BACKGROUND AND OBJECTIVE:Transitions from the hospital to home can be difficult for patients and families. Family-informed characterization of this vulnerable period may facilitate the identification of interventions to improve transitions home. Our objective was to develop a comprehensive understanding of hospital-to-...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2015-2098

    authors: Solan LG,Beck AF,Brunswick SA,Sauers HS,Wade-Murphy S,Simmons JM,Shah SS,Sherman SN,H2O Study Group.

    更新日期:2015-12-01 00:00:00

  • Vitamin K1 (phylloquinone) and vitamin K2 (menaquinone) status in newborns during the first week of life.

    abstract::Since 1961 the Committee on Nutrition of the American Academy of Pediatrics has recommended that prophylactic vitamin K be administered parenterally to all newborn infants, although the exact requirement for vitamin K in the newborn infant is unknown. There is little information about the vitamin K1 (phylloquinone, pr...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Greer FR,Mummah-Schendel LL,Marshall S,Suttie JW

    更新日期:1988-01-01 00:00:00

  • Incidence of rash after amoxicillin treatment in children with infectious mononucleosis.

    abstract:BACKGROUND:"Ampicillin rash," a phenomenon unique to patients with Epstein-Barr virus acute infectious mononucleosis (AIM) treated with ampicillin, was first reported in the 1960s. The incidence was estimated as being between 80% and 100%, and the figures have not been reviewed since those first accounts. We sought to ...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.2012-1575

    authors: Chovel-Sella A,Ben Tov A,Lahav E,Mor O,Rudich H,Paret G,Reif S

    更新日期:2013-05-01 00:00:00

  • Population case-control study of cerebral palsy: neonatal predictors for low-risk term singletons.

    abstract:OBJECTIVES:For singletons with cerebral palsy (CP) who were born at term, the goals were (1) to determine the proportion not admitted to a Special Care Unit/NICU (NICU), (2) to compare clinical descriptions of those admitted to NICUs and those not admitted, and (3) to identify neonatal predictors of CP among those not ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2010-1894

    authors: McIntyre S,Badawi N,Brown C,Blair E

    更新日期:2011-03-01 00:00:00

  • Menstruation in girls and adolescents: using the menstrual cycle as a vital sign.

    abstract::Young patients and their parents often are unsure about what represents normal menstrual patterns, and clinicians also may be unsure about normal ranges for menstrual cycle length and amount and duration of flow through adolescence. It is important to be able to educate young patients and their parents regarding what ...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2006-2481

    authors: American Academy of Pediatrics Committee on Adolescence.,American College of Obstetricians and Gynecologists Committee on Adolescent Health Care.,Diaz A,Laufer MR,Breech LL

    更新日期:2006-11-01 00:00:00

  • Dyssomnias and parasomnias in early childhood.

    abstract:OBJECTIVES:Our aim for this study was to determine the prevalence of dyssomnias and various parasomnias in early childhood and to describe their temporal evolution, gender differences, and correlates. METHODS:This research is part of a longitudinal study of child development. A randomized, 3-level, stratified survey d...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-2132

    authors: Petit D,Touchette E,Tremblay RE,Boivin M,Montplaisir J

    更新日期:2007-05-01 00:00:00

  • Screening for Speech and Language Delay and Disorders in Children Aged 5 Years or Younger: US Preventive Services Task Force Recommendation Statement.

    abstract:BACKGROUND:This report is an update of the US Preventive Services Task Force (USPSTF) 2006 recommendation on screening for speech and language delay in preschool-aged children. METHODS:The USPSTF reviewed the evidence on screening for speech and language delay and disorders in children aged 5 years or younger, includi...

    journal_title:Pediatrics

    pub_type: 杂志文章,实务指引

    doi:10.1542/peds.2015-1711

    authors: Siu AL,US Preventive Services Task Force.

    更新日期:2015-08-01 00:00:00