Abstract:
OBJECTIVES:To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario. METHODS:Children who presented with fever and had presumptive clinical diagnosis of pneumonia were evaluated in 4 institutions of different complexity during 1 year. The variables assessed were sex, age, respiratory rate, days with fever, maximum body temperature, presence of tachypnea, cough, chest pain, intercostal retraction, nasal flaring, abdominal pain, vomiting, grunting, rales, decreased breath sounds, wheezing, fatigue, loss of appetite, loss of sleep, and season of the year. The chest radiographs were photographed and then interpreted by 2 pediatric radiologists. RESULTS:A total of 257 children were evaluated: 179 (69%) had clinical and radiological diagnosis of community-acquired pneumonia, and 78 (30%) had no radiological confirmation. A total of 96 photographs were recorded, and in 64 of the cases, there was agreement in the diagnosis between the evaluating pediatrician and the radiologists (kappa index = 0.68).With the calculated probabilities, it was possible to build a receiving operating characteristic curve and, based on the estimated coefficients we calculated, a value associated to the probability of having pneumonia. CONCLUSIONS:We developed a model including 5 variables of high level of sensitivity for the diagnosis of pneumonia. To use it, it would be useful to apply the appropriate software. In addition, we validated a clinical prediction rule of 4 variables that proved to have 93.8% sensitivity to diagnose pneumonia in children with a fever and localized rales, or decreased breath sounds, or tachypnea, or any combination of these 4 variables.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Bilkis MD,Gorgal N,Carbone M,Vazquez M,Albanese P,Branda MC,Alterman E,Rodriguez D,Orellana L,Pedrosa OBdoi
10.1097/PEC.0b013e3181e05779subject
Has Abstractpub_date
2010-06-01 00:00:00pages
399-405issue
6eissn
0749-5161issn
1535-1815journal_volume
26pub_type
杂志文章,多中心研究abstract::Securing the pediatric airway in the emergency setting is an uncommon event that is complicated by anatomic, physiologic, and environmental factors. Even more uncommonly, practitioners are faced with the added complication of a difficult airway, and the question of what alternatives to traditional endotracheal intubat...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000093
更新日期:2014-03-01 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::Diaphragmatic hernia in pediatric emergency department poses a diagnostic challenge because of the acute or subtle timing of onset and the wide variety of clinical features. We describe 3 different late presentations of Bochdalek diaphragmatic hernia in a pediatric emergency department. These reports may help physicia...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000425
更新日期:2015-05-01 00:00:00
abstract::A 17-year-old adolescent girl with no past medical history presented to the emergency department with a chief complaint of lower back pain after sustaining a minor fall several hours earlier. Physical examination revealed mild to moderate back tenderness, and the result of review of systems was negative. Laboratory ev...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181bec953
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:The duration of a specific event during an emergency and the duration of time from the event until medical evaluation are important components of a detailed history and may influence management decisions. We sought to determine whether a caregiver is accurate in their recollection of the passage of time relat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000278398.70870.4f
更新日期:2007-06-01 00:00:00
abstract::The delayed presentation of a congenital diaphragmatic hernia may include symptoms of acute respiratory distress or gastrointestinal obstruction. We review the presentation and management of the different types of diaphragmatic hernias. In addition, we present a case of twins with a left-sided congenital diaphragmatic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200108000-00013
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the epidemiology of nonfatal consumer product- and sports and recreational activity-related injuries among US children. METHODS:National Electronic Injury Surveillance System data regarding children younger than 18 years who were treated in US emergency departments (E...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001778
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:This study aimed to assess urban adolescents' knowledge of and attitudes about emergency contraception (EC) and to assess the intention to use EC in particular hypothetical situations. We hypothesized that knowledge about EC would be limited, but that adolescents would support using EC in certain situations....
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31828a3249
更新日期:2013-04-01 00:00:00
abstract::Hip pain and fever in children include a broad differential. Most concerning is the possible diagnosis of a septic joint, which carries significant morbidity. We describe the case of a 13-year-old boy with fever and hip pain who was referred to the emergency department with concern for septic hip. The etiology was lat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000328
更新日期:2015-01-01 00:00:00
abstract::We report a case of a six-year-old male who sustained a ventricular septal defect following blunt trauma to the chest. Traumatically acquired VSD is rare in children. The diagnosis is made by characteristic history and physical examination and confirmed by echocardiogram or cardiac catheterization. Treatment is medica...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198612000-00009
更新日期:1986-12-01 00:00:00
abstract::Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000591
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Trauma is a leading cause of death among children. Detailed knowledge of the epidemiology of traumatic childhood deaths is necessary for allocating available treatment resources and for preventing injuries at both community and regional levels. To our knowledge, there has been no report comparing urban to rur...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e31827b50a7
更新日期:2013-01-01 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::It has been estimated that up to 27% of all medical emergencies presenting to emergency departments are due to hypertension, predominantly in the adult population. Although this often is an insidious process, acutely, a hypertensive emergency occurs when a patient presents with severe hypertension and evidence of end ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181a34816
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:Timely delivery of β-agonists and steroids to patients with acute recurrent wheezing is a key component of the National Heart, Lung, and Blood Institute recommended emergency department (ED) asthma care. We conducted an ED improvement initiative to standardize asthma care and improve time to treatments. METH...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001249
更新日期:2017-09-01 00:00:00
abstract::We illustrate a case of an 8-year-old boy presenting acutely with bilateral lower extremity pain and weakness. This case illustrates the presentation and progression of a rare and potentially lethal diagnosis and highlights the use of computed tomography angiography in the setting of a patient with acute onset of pain...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31822c2896
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of a single dose of oral dexamethasone (Dex) versus 5 days of twice-daily prednisolone (Pred) in the management of mild to moderate asthma exacerbations in children. STUDY DESIGN:A prospective, randomized, double-blinded trial of children 2 to 16 years of age who presented to the emer...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.pec.0000248683.09895.08
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:Pediatric aeromedical transport (AT) is highly challenging. We aim to describe a series of 96 cases of children requiring medical transport in terms of the indication, modalities, and related adverse events. METHODS:In this single-center retrospective study, we included air-transported patients less than 18 ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001308
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To determine whether application of topical aqueous lidocaine to a laceration attenuates the pain from the subsequent lidocaine injection in children. DESIGN:Prospective, double-blind study. SETTING:A large, urban, tertiary care children's hospital emergency department. PATIENTS:A convenience sample of 100...
journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1097/00006565-199812000-00012
更新日期:1998-12-01 00:00:00
abstract::Chronic hematomas are defined as hematomas with slow, progressive growth over many weeks. They are an extremely rare cause of acute neck swelling in the pediatric population. They consist of an organized central mass of blood with granulation tissue and fibrotic changes peripherally. The presence of a capsule prevents...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001402
更新日期:2018-02-01 00:00:00
abstract::Clinical signs of hypophosphatemia, even when severe, are rare in diabetic ketoacidosis despite their high frequency in this condition. This article presents a patient with rhabdomyolysis due to severe hypophosphatemia, where the level of serum phosphorus was observed to be as low as 0.42 mg/dL on the 16th hour of ket...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31821dc68a
更新日期:2011-06-01 00:00:00
abstract::The objective of this study was to examine the appropriateness of utilization of an urban pediatric emergency department (ED) by children who had a pediatrician and factors relating to whether the pediatrician was called before an ED visit. This was done prospectively and randomly in an urban teaching hospital pediatr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199402000-00004
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:There have been increasing job opportunities for pediatric emergency medicine (PEM) specialists within community emergency departments (CEDs), where 90% of children receive emergency care. The majority of training for PEM fellows occurs in academic children's hospitals, which may expose fellows to different r...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002103
更新日期:2020-09-15 00:00:00
abstract:OBJECTIVES:This study examined whether utilization of the Florida State Health Online Tracking System (SHOTS) immunization registry to determine Haemophilus influenzae type B and heptavalent pneumococcal conjugate (PCV7) vaccine status impacts the protocolized decision to perform a screening blood draw for occult bacte...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31825cfd3e
更新日期:2012-07-01 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:PURPOSE:This study aimed to compare clinical manifestations, physical examination findings, laboratory, and radiographic dates in pediatric patients with different pathological diagnoses of acute scrotum as well as to accurately establish the true incidence of various pathological diagnoses of acute scrotum. METHODS:T...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318213144e
更新日期:2011-04-01 00:00:00
abstract::The umbilical hernia is common in children. Most of the cases have a spontaneous regression around the age of 3 years. Complications are very rare, and thus surgery is not routinely indicated before the age of 3 years. We report an exceptional case of spontaneous rupture of an umbilical hernia with emphasis on the man...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002200
更新日期:2020-09-01 00:00:00
abstract::Astemizole (Hismanal-Janssen, New Brunswick, NJ) is a nonsedating antihistamine that has the advantage of a once-daily dosage schedule. This article reports the case of a 14-year-old female who intentionally ingested 270 mg of Astemizole and developed torsade de pointes, a form of polymorphic ventricular tachycardia t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199302000-00008
更新日期:1993-02-01 00:00:00
abstract::Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple systems, and its various symptoms are often mistaken for other diseases. This case report describes a 15-year-old girl who presented to the emergency department with complaints of diffuse abdominal pain, facial swelling, joint pain, low-gra...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001066
更新日期:2019-01-01 00:00:00
abstract::Tears of the lingual and labial frena have been associated with accidental and nonaccidental injury. Three cases of infants are presented who were evaluated in the hospital with frena tears which were not recognized as manifestations of abuse, discharged home, and subsequently returned with manifestations of severe ab...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181568039
更新日期:2007-10-01 00:00:00