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 emergency department (ED) with acute mild to moderate asthma exacerbations. Subjects received single-dose oral Dex (0.6 mg/kg to a maximum of 18 mg) or oral Pred (1 mg/kg per dose to a maximum of 30 mg) twice daily for 5 days. After discharge, subjects were contacted by telephone at 48 h to assess symptoms and reevaluated in the ED in 5 days. The primary outcome was the number of days needed for Patient Self Assessment Score to return to baseline (score of 0-0.5). MAIN RESULTS:Baseline characteristics of the 2 groups were similar. The mean number of days needed for Patient Self Assessment Score to return to baseline (0-0.5) in the Dex and Pred groups were 5.21 versus 5.22 days, respectively (mean difference, -0.01; confidence interval, -0.70, 0.68). Pulmonary index scores were similar in both groups at initial presentation, initial ED discharge and at the day 5 follow-up visit. At the first visit, mean time to discharge was 3.5 h (+/-1.93)for Dex and 4.3 h (+/-3.67) for Pred (mean difference, -0.8; confidence interval, -1.8, 0.2). Initial admission rate was 9% (Dex) versus 13.4% (Pred). There was no significant difference in the number of salbutamol therapies needed in the ED nor at home after discharge. For subjects discharged home, the admission rate after initial discharge was 4.9% (Dex) versus 1.8% (Pred), resulting in overall hospital admission rates of 13.4% (Dex) and 14.9% (Pred). CONCLUSION:A single dose of oral Dex (0.6 mg/kg) is no worse than 5 days of twice-daily prednisolone (1 mg/kg per dose) in the management of children with mild to moderate asthma.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Altamimi S,Robertson G,Jastaniah W,Davey A,Dehghani N,Chen R,Leung K,Colbourne Mdoi
10.1097/01.pec.0000248683.09895.08subject
Has Abstractpub_date
2006-12-01 00:00:00pages
786-93issue
12eissn
0749-5161issn
1535-1815pii
00006565-200612000-00003journal_volume
22pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:We present a case of Kasabach-Merritt syndrome with discussion of hemangiomas of childhood relevant to the emergency physician. DESIGN:This is a case report. SETTING:The case is described in the setting of a tertiary care hospital level I pediatric emergency department. PATIENTS:A single case is discussed....
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199612000-00009
更新日期:1996-12-01 00:00:00
abstract::A survey was conducted to determine the current standard of care with regard to team composition and training, mobilization time, and vehicle use for pediatric critical care transport. An evaluation of 30 pediatric referral centers revealed that 60% provide a critical care transport team. Of those teams, the mean numb...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::The ingestion of foreign bodies remains a common occurrence in children. Most ingested foreign bodies pass spontaneously, although up to 1% will result in intestinal perforation. Specific foreign bodies such as sharp, pointed, or corrosive objects have been typically associated with perforation. The initial diagnosis ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3180302be6
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:Trauma is the leading cause of death in children. The quality of initial medical care received by injured children contributes to outcomes. Our objective was to assess effectiveness of an educational intervention on performance of emergency department (ED) teams during simulated pediatric trauma resuscitatio...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e31815a0653
更新日期:2007-11-01 00:00:00
abstract::Caring for children of adolescent parents presents unique challenges. Because adolescent parents may lack parenting skills and knowledge of medical terminology, symptoms of life-threatening illnesses may be misinterpreted. We present two cases of unexpected acute abdomen in young infants with adolescent mothers. The f...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200112000-00022
更新日期:2001-12-01 00:00:00
abstract::Priapism is an adverse effect of medications used to treat psychiatric disorders. Often, this condition is self-limiting but may require urologic intervention involving aspiration and injection to induce detumescence. A case of a 15-year-old patient with priapism secondary to a long-acting stimulant is presented to de...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000485
更新日期:2015-07-01 00:00:00
abstract::Corn starch powder is widely used for routine infant skin care as a substitute for talcum powder, as it is believed to have fewer respiratory hazards. We describe a one-month-old infant who presented to an emergency department with respiratory failure and a severe pneumonitis from aspiration of corn starch powder. The...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199604000-00011
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:Real-time audiovisual consultation (telemedicine) has been proven feasible and is a promising alternative to interfacility transfer. We sought to describe caregiver perceptions of the decision to transfer his or her child to a pediatric emergency department and the potential use of telemedicine as an alternat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000957
更新日期:2019-03-01 00:00:00
abstract::Ultrasonography can be useful in the evaluation of children with abdominal complaints and may be the initial imaging modality in patients presenting with a newly recognized abdominal mass. Hepatoblastoma is an uncommon cause of acute abdominal pain in children and can rarely metastasize to the heart through vascular i...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001629
更新日期:2018-10-01 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 study aimed to measure interexaminer agreement for physical examination (PE) findings in children with a suspected soft tissue abscess. METHODS:A prospective study was conducted from March 1 to July 31, 2007, at an urban, tertiary care children's hospital emergency department. Children presenting to the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31821d8545
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Obtaining intravascular access can be challenging or even impossible in several clinical situations. As an alternative, medications and fluids can be administered via the intraosseous (IO) route, which is a well-tolerated and established alternative, especially in the emergency setting. METHODS:Seventy-five...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001587
更新日期:2020-10-01 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::Serious blunt scrotal trauma in the pediatric population is rare and can pose significant danger to the viability of the testes. The following case describes an adolescent boy who presented with a single testis in his scrotum after low-impact perineal trauma, consistent with testicular dislocation. The literature rega...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000270
更新日期:2014-11-01 00:00:00
abstract::Emergency department (ED) overcrowding has been a serious issue on the national agenda for the past 2 decades and is rapidly becoming an increasingly significant problem for children. The goal of this report is to focus on the issues of overcrowding that directly impact children. Our findings reveal that although over...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000280518.36408.74
更新日期:2007-07-01 00:00:00
abstract::We report a case of a child with sickle cell disease and decreased intravascular volume secondary to splenic sequestration in whom a femoral venous catheter dislodged, infiltrated into the soft tissue of the anterior abdominal wall, and caused clinical signs of peritonitis. Inability to recognize this complication led...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198803000-00009
更新日期:1988-03-01 00:00:00
abstract::Intraosseous needle insertion and infusion is considered an easy and reliable method of achieving a vascular access in acute circulatory collapse where other methods have not been successful within reasonable time. Complications are considered few but may be serious. We present a case of a newborn girl, where intraoss...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000150
更新日期:2014-06-01 00:00:00
abstract::Herlyn-Werner-Wunderlich (HWW) syndrome is a rare müllerian duct anomaly with uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. Patients with this syndrome generally present after menarche with pelvic pain and mass and, rarely, primary infertility in later years. Strong suspicion and ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000052
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of and to identify factors associated with prolonged emergency department length-of-stay (ED-LOS) for admitted children. METHODS:Data were from the 2001-2006 National Hospital Ambulatory Medical Care Survey. The primary outcome was prolonged ED-LOS (defined as total ED time >8 hour...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820943e4
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to measure the impact of a simple parent health literacy intervention on emergency department and primary care clinic usage patterns. METHODS:Study participants consisted of parents who brought their children to the Harbor-UCLA Medical Center pediatric emergency department for nonur...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181ab78c7
更新日期:2009-07-01 00:00:00
abstract::The recent popularity of elastic bands on the wrist may put children at risk for acute compartment syndrome. Acute compartment syndrome is a limb-threatening condition characterized by elevated interstitial pressure in a confined fascial compartment. If left untreated, it may result in tissue necrosis, irreversible ne...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318217b5a7
更新日期:2011-05-01 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
abstract::Enterobius vermicularis may cause infections of the gastrointestinal tract and occurs approximately in 4% to 28% of children worldwide. It is most common in children aged 5 to 14 years.The most commonly reported symptoms are pruritus in the perianal region, abdominal pain, urinary tract infection, insomnia, irritabili...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000480
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:Radiographic survey of the entire aerodigestive tract (nares to anus) is common practice in children presenting to the emergency department following coin ingestion. The purpose of our study was to determine the optimal protocol for radiographic survey post-coin ingestion. We hypothesized that for children p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001688
更新日期:2018-11-19 00:00:00
abstract:INTRODUCTION:To determine whether a delineation of suicide attempt severity via toxic ingestion distinguishes adolescents in terms of needs for medical and psychosocial support. METHODS:Cross-sectional study performed between 1995 through 1997 in which 92 adolescents, mean age 15.6 years, presented to an urban pediatr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000134925.08868.42
更新日期:2004-07-01 00:00:00
abstract::Tooth decay is common in US children, especially for children in low-income families. More than half of second-grade children have cavities. Therefore, root canal procedures are becoming more common in children. We report a case of a 2-year-old boy with a rare complication of a root canal procedure secondary to sodium...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318226e166
更新日期:2011-08-01 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:Methamphetamine (meth) abuse in the rural South has increased greatly in the last decade. This addiction harms meth abusers and producers and endangers children who live with them. Appropriate medical evaluation and treatment of these exposed children are largely undefined. The objective of this research was...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181558d72
更新日期:2007-10-01 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::Of the multitude of neurologic injuries related to roller-coaster rides, a majority of them are reported about adults. In this case, we present a patient who presented to the pediatric emergency department with new-onset seizure and hemiplegia 2 days after a roller-coaster ride. She was ultimately diagnosed with a sub...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001802
更新日期:2019-04-01 00:00:00