Abstract：
OBJECTIVES:Although mild stress hyperglycemia in pediatric illness is common, severe hyperglycemic responses (≥300 mg/dL [16.7 mmol/L]) to stress are unusual. We sought to determine the incidence and course of extreme stress hyperglycemia (ESH) in acute pediatric illness, including whether it is a marker of increased mortality or associated with subsequent development of diabetes mellitus (DM). METHODS:We retrospectively reviewed a cohort of 55,120 consecutive visits over 6 years to a pediatric emergency department at which blood glucose concentrations were measured and report on visits with laboratory glucose 300 mg/dL (16.7 mmol/L) or greater without DM. RESULTS:There were 72 cases of ESH (incidence of 0.13%). Median age was 8.8 years; 63% were male. The most common diagnoses were respiratory illness (49%), trauma (15%), and seizure (8%), and 65% of patients had received glucose-influencing interventions before evaluation. Eighty-five percent were ill appearing, 60% were admitted to the intensive care unit, and half had acidemic pH values. The overall mortality rate was 22%. Despite treatment of hyperglycemia in only 8 patients, glucose concentrations decreased to 150 mg/dL (8.3 mmol/L) or less within 48 hours in 67% and before discharge or death in 85% of patients. Preceding symptoms and concurrent laboratory results were helpful to exclude diabetes, and none of the surviving patients with follow-up available went on to develop type 1 or 2 DM. CONCLUSIONS:Although rare, ESH (≥300 mg/dL [16.7 mmol/L]) does occur in acute pediatric illness, in most cases is at least partially iatrogenic, and is a marker of severe illness and high mortality. Normoglycemia is typically restored quickly with treatment of the primary illness. No association was found with a subsequent diagnosis of DM.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Weiss SL,Alexander J,Agus MSdoi
10.1097/PEC.0b013e3181ef0488subject
Has Abstractpub_date
2010-09-01 00:00:00pages
626-32issue
9eissn
0749-5161issn
1535-1815journal_volume
26pub_type
杂志文章abstract：:Pediatric emergency medicine physicians may be able to use point-of-care ultrasound (POCUS) as a tool to evaluate abdominal wall masses. We present a case of a 2-month-old infant with a lower abdominal mass identified as a hernia sac by POCUS. It was initially thought to represent a Spigelian-type abdominal wall herni...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000001222
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Poisoning is the leading cause of injury death in pediatric patients. Hospital and provider readiness, including pharmacy stocking, depends on reliable surveillance data describing local patterns of age-specific clinically significant exposures and the therapeutic modalities employed in their t...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000001893
更新日期：2019-08-23 00:00:00
abstract：OBJECTIVE:The aim of the study was to evaluate, in children undergoing procedural sedation for magnetic resonance imaging (MRI) scans, whether lower doses of propofol than previously published permitted a high rate of successful MRI completion, whether lower dosages result in a more rapid recovery, and whether age or b...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000002289
更新日期：2020-11-11 00:00:00
abstract：:Constipation is a common cause of pediatric abdominal pain seen in pediatric emergency departments (EDs). We present the case of an 11-year-old boy with a 4-month history of chronic constipation and abdominal pain who presented to the children's ED. He was found to have a large abdominal mass that was determined to be...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000000166
更新日期：2014-07-01 00:00:00
abstract：OBJECTIVE:The aim of the study was to investigate the appropriate time of removal of button batteries (BB) from the esophagus and stomach in children. METHODS:This is a retrospective descriptive single-center study reviewing the medical records of all children with BB ingestion seen in the Royal Hospital between Janua...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000001697
更新日期：2018-12-27 00:00:00
abstract：:Neck pain is a relatively common pediatric complaint. Most is of benign etiology. We present an unusual case of epidural abscess with associated discitis in the cervical spine of a 12-year-old after a dental extraction. This potentially dangerous complication was diagnosed before neurological complications developed a...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0b013e3181c8c60b
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVES:The aims of the study were to describe sledding-related injuries among children requiring emergency treatment and assess the use of safety measures before and after these injuries. METHODS:This is a study of a consecutive series of patients treated for sledding-related injuries in the emergency department o...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/01.pec.0000190233.27857.6a
更新日期：2005-12-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to assess whether increased time from emergency department (ED) triage to appendectomy is associated with a greater risk of children developing appendiceal perforation. METHODS:We performed a multicenter retrospective cohort study of children younger than 18 years hospitalized with ...
journal_title：Pediatric emergency care
pub_type： 杂志文章,多中心研究
doi：10.1097/PEC.0000000000000850
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVE:To determine the success rate and complications of using the external jugular (EJ) vein for central venous access in pediatric patients. METHODS:Prospective cohort study of children who underwent attempts at EJ vein central venous access while receiving care in an 11-bed pediatric intensive care unit at an u...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0b013e3181ea71ca
更新日期：2010-08-01 00:00:00
abstract：:Primary tumors of the esophagus are extremely rare in children. A common periesophageal mass in children is duplication. It constitutes only 0.5 to 2.5% of all esophageal lesions usually diagnosed in infancy or early childhood. Duplication of the esophagus may be diagnosed on examination by the emergency department (E...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：
更新日期：1985-06-01 00:00:00
abstract：BACKGROUND:Despite rapidly increasing incidence of skin and soft tissue infections (SSTIs) presenting to emergency departments (EDs), outcome data for these infections are limited. METHODS:This is a retrospective cohort study of children with culture-positive SSTI, managed as outpatients from a large pediatric ED in t...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0b013e318203ca1c
更新日期：2011-01-01 00:00:00
abstract：OBJECTIVES:The study evaluates whether facial landmarks can be used to estimate an appropriate laryngoscope blade length for oral endotracheal intubation in children. We tested the hypothesis that the laryngoscope blade measuring 10 mm or less distal or proximal to the angle of the mandible (when the flat portion of th...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/01.pec.0000210171.17892.7a
更新日期：2006-04-01 00:00:00
abstract：OBJECTIVES:Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center. METHODS...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000001642
更新日期：2018-10-17 00:00:00
abstract：OBJECTIVES:To ascertain the incidence, determinants, and outcome of sepsis workup in febrile infants aged 0-90 days with respiratory syncytial virus (RSV) infection. DESIGN:Retrospective chart review. RESULTS:191 infants with RSV, 21.5% younger than 28 days, were identified; 101 (52.9%) were febrile and 90 were afebr...
journal_title：Pediatric emergency care
pub_type： 杂志文章,评审
doi：10.1097/01.pec.0000092576.40174.28
更新日期：2003-10-01 00:00:00
abstract：:We describe two related cases of pertussis infection ("whooping cough"). This disease entity was almost completely eradicated through successful mass immunization programs. In the past decade it has demonstrated a steady rise in incidence. The epidemiology, clinical manifestations, treatment, and current vaccines for ...
journal_title：Pediatric emergency care
pub_type： 杂志文章,评审
doi：
更新日期：1993-08-01 00:00:00
abstract：OBJECTIVE:To evaluate the utility of a simple scoring system as a predictor of obtaining a positive throat culture for group A streptococci (GAS). DESIGN:Prospective descriptive study. Scores were assigned prior to the availability of the results of throat cultures. SETTING:Emergency department and walk-in clinic of ...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/00006565-199804000-00005
更新日期：1998-04-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to increase education and awareness among pediatric practitioners of possibility of simultaneous hemophagocytic lymphohistiocytosis and Kikuchi-Fujimoto disease/Kikuchi disease occurring in the pediatric population and the diagnostic dilemma it can present. We describe a case presen...
journal_title：Pediatric emergency care
pub_type： 杂志文章,评审
doi：10.1097/PEC.0000000000000560
更新日期：2016-11-01 00:00:00
abstract：:The use of the emergency department by children on Medicaid was documented, and the effect of new adult Medicaid criteria on a pediatric emergency department was investigated. Eight percent of daytime visits by all patients were nonemergencies, compared to 15% by Medicaid patients. More Medicaid patients required admi...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/00006565-198709000-00003
更新日期：1987-09-01 00:00:00
abstract：OBJECTIVE:This review examines the screening instruments that are in existence today to identify commercially sexually exploited children. The instruments are compared and evaluated for their feasibility of use in an emergency department setting. METHODS:Four electronic databases were searched to identify screening in...
journal_title：Pediatric emergency care
pub_type： 杂志文章,评审
doi：10.1097/PEC.0000000000001020
更新日期：2017-12-01 00:00:00
abstract：OBJECTIVE:Acutely ill infants and children presenting to the emergency department are treated by either physicians with pediatric emergency medicine (PEM) training or physicians without PEM training, a good proportion of which are general emergency medicine-trained physicians (GEDPs). This scoping review identified pub...
journal_title：Pediatric emergency care
pub_type： 杂志文章,评审
doi：10.1097/PEC.0000000000000557
更新日期：2017-04-01 00:00:00
abstract：:Rubber band syndrome is a rare entity seen in younger children mainly in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovas...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000000992
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:To increase the evidence base by characterizing various features of pediatric sports-related abdominal injuries. DESIGN:A review of the trauma database at The Children's Hospital at Westmead was undertaken for all abdominal injuries presenting to the emergency department between 2001 and 2006. SETTING:The C...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0b013e3181cd7f3f
更新日期：2010-01-01 00:00:00
abstract：:The etiology of acute liver failure varies widely in children, but the most common causes are viral hepatitis, drugs, and toxins. We report herein a case of autoimmune hepatitis and acute liver failure caused by leptospirosis, which is involved rarely in etiology. ...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0b013e3182309e79
更新日期：2011-10-01 00:00:00
abstract：OBJECTIVES:The objectives of the study were to identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. METHODS:We performed a secondary analys...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000000421
更新日期：2015-05-01 00:00:00
abstract：PURPOSE:To describe a series of patients seen in a pediatric emergency department with adverse effects following an ingestion of a caterpillar. METHODS:Case series. RESULTS:Ten patients presented to the emergency department following ingestion of a caterpillar. Adverse effects ranged from drooling and refusal to drin...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：
更新日期：1999-02-01 00:00:00
abstract：:Bone and joint infection complicating tuberculosis is most likely to involve vertebrae. Pott disease, or tuberculous spondylitis, represents a small proportion of tuberculosis cases, but it can be associated with significant morbidity and mortality. Our case report details Pott disease in a teenage girl, which present...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0b013e3181fb0e38
更新日期：2010-11-01 00:00:00
abstract：:Visual disturbances resulting from acute nerve paralysis of the muscles controlling eye movements can be challenging to evaluate in the pediatric population. Children may not be capable of describing symptoms or providing an adequate history. Therefore, it is important to have an understanding of the anatomical course...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000000391
更新日期：2015-05-01 00:00:00
abstract：:A 6-year-old boy presented to the pediatric emergency department with a unilateral 5 × 3-cm superficial mass on the postauricular region growing for 1 month. Point-of-care ultrasound was used to evaluate the mass, which revealed a complex cystic mass penetrating the temporal bone. After confirmatory magnetic resonance...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000001092
更新日期：2017-04-01 00:00:00
abstract：:Pediatric rapid sequence intubation is a skill of great importance to emergency medicine physicians. Developing a systematic strategy for approaching an emergent airway aids in the proper handling of this event. This paper is a review of the current recommendations for pediatric rapid sequence intubation including cur...
journal_title：Pediatric emergency care
pub_type： 杂志文章,评审
doi：10.1097/01.pec.0000125667.58561.62
更新日期：2004-05-01 00:00:00
abstract：:Colchicine is an anti-inflammatory drug, which has been used for the treatment of familial Mediterranean fever for several decades with narrow therapeutic-toxicity window. Colchicine poisoning is rare but frequently a life-threatening emergency condition in pediatric practice. It may occur by excessive ingestion of co...
journal_title：Pediatric emergency care
pub_type： 杂志文章
doi：10.1097/PEC.0000000000000545
更新日期：2015-09-01 00:00:00
