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At least 19 recordsLinked to original sources
PubMed2026

Re-evaluating pediatric laryngoscope blade size recommendations: Comparable intubation performance across blade sizes in pediatric manikin models.

BACKGROUND: Pediatric airway management traditionally emphasizes strict adherence to age-based laryngoscope blade size recommendations, despite limited empirical validation. OBJECTIVES: To evaluate whether intubation performance varies across a range of blade sizes, and whether a Macintosh 2 blade performs comparably across multiple pediatric age groups in a simulation setting. METHODS: We conducted a randomized crossover simulation study using three pediatric airway manikins (neonate, infant, and child age groups). Emergency medicine residents and faculty physicians performed intubations using multiple laryngoscope blade types and sizes, including standard and nonstandard options. Primary outcomes were intubation time and first-attempt success. Secondary outcomes included complications and operator-rated ease of glottic view and tube passage. Between-blade differences were estimated with 95% confidence intervals. RESULTS: Across manikin sizes and blade types, intubation times were short and first-attempt success rates exceeded 98% in most conditions. Performance remained consistent even with blade sizes outside conventional age-based recommendations. Between-blade differences in intubation time were small, and complication rates were low across conditions. The Macintosh 2 blade performed comparably across all manikin sizes, with similar intubation times, high success rates, and favorable ease ratings. CONCLUSIONS: Intubation performance in pediatric manikin models was similar across a wide range of blade sizes. These hypothesis-generating findings warrant prospective clinical evaluation of simplified blade selection strategies for pediatric intubation.

Manikins↗
PubMed1976

Pediatric-psychiatric liaison as a model for teaching pediatric residents.

The pediatrician's function as a comprehensive family health practitioner has frequently been ignored. A major problem is that pediatric residents are not trained or are inadequately trained to assess emotional, behavioral, and family problems that may be an integral part of the patient's symptoms. At the Children's Hospital of Philadelphia, a pediatric-psychiatric liaison program has evolved in which pediatric residents learn the principles and skills necessary to manage these problems. Ultimately, the liaison program will enable the staff pediatricians who use these principles to assume appropriate responsibility for educating the pediatric trainees.

Child Psychiatry↗
PubMed1978

[Pediatric bibliometrics: II. Descriptive statistics on pediatric periodicals and papers (author's transl)].

A descriptive statistic study about journals and pediatric articles at international level is presented. Three of the main international repetories of medical bibliography, have been used as sources, collecting a total of three hundred periodical pediatric publications. A distribution of these publications by languages, places or impression, periodicity of appearance and percent of sub-specialization is made. In relation with pediatric papers, we have studied their presence in non medical scientific journals, medical but non pediatric journals and in those of the speciality, analizing the percentage of these papers in each one of them.

Pediatrics↗
PubMed1992

Screening for psychosocial dysfunction in pediatric practice. A naturalistic study of the Pediatric Symptom Checklist.

This study examined the routine implementation of the Pediatric Symptom Checklist (PSC), a brief questionnaire which screens for psychosocial dysfunction in school-aged children in an outpatient pediatric practice. Results indicated that the PSC was well-accepted by parents and adequately tolerated by busy clinic staff. When the PSC was included as part of the standard procedure for well-child visits, the referral rate for psychosocial problems due to positive PSC scores rose to 12% from the clinic baseline referral rate of 1.5%, a significant increase (P < .01). Half of the children who screened positive on the PSC had not been previously identified by their pediatricians as having psychosocial problems, and more than half had never received any psychological treatment. When implementation of the PSC was discontinued, the referral rate fell to 2%, a rate similar to baseline. The findings suggest that it is possible to incorporate the PSC into routine pediatric practice and that the PSC can help pediatricians identify and better serve children experiencing psychosocial difficulties. The study also suggests that further work is needed to understand the barriers to ongoing implementation.

Adolescent↗
PubMed1992

The effect of donor age on graft survival in pediatric cadaver renal transplant recipients--a report of the North American Pediatric Renal Transplant Cooperative Study.

Data from the North American Pediatric Renal Transplant Cooperative Study were analyzed to determine the effect of donor age on graft survival for pediatric recipients of cadaver donor renal transplants. Between January 1, 1987, and November 16, 1990, 787 cadaver donor renal transplants in children less than 18 years of age were registered in the study. The ages of the donors were less than or equal to 5 years in 203 transplants, between 6 and 9 years in 87, between 10 and 39 in 389, and greater than or equal to 40 years in 108. The risk of graft loss was related to donor age by a proportional hazards analysis. The ideal donor age was 20-25 years. The risk of graft loss was increased by both young and old donor age. The risk of graft loss from a neonate donor was 2.7-fold that of the ideal donor, and the risk from a 50-year-old donor was 1.8-fold that of the ideal donor. The relationship between donor age and graft survival was not affected by the age of the recipient. Cold storage time had an added impact on graft survival: grafts with cold storage time greater than 24 hr were 1.5 times more likely to fail than grafts with shorter cold storage time for all donor ages. Analysis of the causes of graft failure revealed that 9.9% of grafts from donors less than or equal to 5 years of age were lost due to vascular thrombosis, primary nonfunction, and other technical causes, compared with 4.6% in 6-9, 4.4% in 10-39, and 2.8% in greater than or equal to 40-year-old donors. We conclude that kidneys from both young and old donors are at increased risk for graft loss, and this increased risk is seen in all recipient age groups. Many of the losses from the young donors--but not older donors--may be due to technical causes. Knowledge of these risks can be used to develop strategies for optimal utilization of kidneys from young and old donors.

Adolescent↗
PubMed1975

[Cardiac surgery at the pediatric surgery clinical department of the Pediatric Institute, Medical Academy, Poznań (author's transl)].

In the 18 months since the opening of a new Pediatric Surgery Clinical Department of the Pediatric Institute in Poznań, an artificial heart-lung apparatus for perfusions in children was developed in collaboration with the PONAR-WIEPOFAMA factory. During this time 40 cardiac operations were performed including 11 open heart procedures. Among 40 cases operated, 6 died; 3 after open heart operations: 1 tetralogy of Fallot, and 2 cases of VSD combined with PDA and pulmonic valve stenosis. 3 infants died after surgery undertaken in the presence of severe uncontrollable heart failure. The overall mortality was 15%.

Adolescent↗
PubMed1992

[Overall clinical evaluation of cefprozil against infections in pediatric fields. Pediatric Study Group for Cefprozil].

Cefprozil (CFPZ, BMY-28100) granule preparation was studied for pharmacokinetic, bacteriological and clinical aspects in the pediatric infections. The results obtained are summarized as follows: 1. Serum concentrations and urinary excretion. The pharmacokinetics of CFPZ in pediatrics was investigated by single oral administration of fine granules at doses of 4.0, 7.5 and 15.0 mg/kg. Peak blood levels of CFPZ were 3.06, 4.62 and 9.65 micrograms/ml, respectively, at 1.00-1.30 hours after each dose and AUCs were 7.44, 12.50 and 27.01 micrograms.hr/ml, respectively. These data showed that Cmax and AUC depended on dose levels. T 1/2 (beta) at these dose levels were 1.03, 0.94 and 1.01 hours, respectively. There were no differences related to dose. Urinary recovery rates in the first 6 hours after administration were 51.5-57.1%. The pharmacokinetics of CFPZ before or after meals were also investigated at a dose of 7.5 mg/kg. Peak blood levels were 4.88 micrograms/ml at 1.17 hours after administration in the fasting state, and 4.30 micrograms/ml at 1.54 hours after administration in the non-fasting state. Delay of Tmax and slight decrease of Cmax were observed in the non-fasting state, but T 1/2 and AUC were 0.91 hour and 12.96 micrograms.hr/ml, respectively, in the non-fasting state, and were similar to those in the fasting state, 0.93 hour and 12.82 micrograms.hr/ml, respectively. Urinary recovery rates in the first 6 hours after administration were 63.8% in the fasting state and 50.7% in the non-fasting state. 2. Clinical results. Clinical efficacies of CFPZ granules in various infectious diseases were studied in 804 cases. Twenty nine cases, mostly viral or mycoplasmal infections, were excluded from the statistical analysis. The clinical efficacy rate in 527 cases with causative bacteria isolated was 97.2%; and in 248 cases from whom no significant isolate had been obtained was 96.0%. The clinical efficacy rate in 475 cases with monobacterial infections (proven by culture of isolates) was 97.3%, and that in 52 case with polybacterial infections was 96.2%. Haemophilus influenzae was isolated mostly from acute respiratory infections. In 88 cases from whom H. influenzae was isolated, clinical efficacy rate was 95.5%. In cases from whom H. influenzae was found concomitant by with Staphylococcus aureus, Streptococcus pyogenes or Streptococcus pneumoniae, the clinical efficacy rates were also high. The bacteriological eradication rate in cases with 582 strains was 83.3%; the eradication rate for Gram-positive organisms was 95.8%; and for Gram-negative organisms, it was 64.2%.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1979

Development and field testing of protocols for the management of pediatric telephone calls: protocols for pediatric telephone calls.

Although telephone calls comprise almost one fourth of all childhood patient-physician contacts, the content of telephone care is not emphasized in most educational and service programs. In response to the need to improve management of telephone calls to our pediatric emergency room, we developed 28 protocols to deal with the 25 most common complaints presented by phone. This paper describes the content of these protocols, the training of the health assistants who administered them, and the measures we took to assure their safety and general utility in pediatric practice settings. The study demonstrates the feasibility of an organized system for telephone care based on protocols which include: (1) basic data to be collected for each chief complaint category; (2) a range of appropriate dispositions; and (3) advice for home management when the patient does not require an immediate medical visit. Potential uses of these protocols for medical and nursing education and for clinical service needs are discussed.

Age Factors↗
PubMed1979

[Pediatric ECG monitoring. 2,500 pediatric patients under anaesthesia (author's transl)].

The authors report 98 cases of cardiac arrhythmia observed in the course of 2,500 pediatric anesthesias performed with constant electrocardiographic monitoring. The patients, aged 0 to 18 years, were in most cases healthy. Anesthesia was performed by different techniques for both surgical and non-surgical interventions for a variety of conditions, both serious and routine. Other than 3 cases of cardiac arrest (1 death) cardiac arrhythmias usually followed a benign course without hemodynamic repercussions. The authors emphasize the value of early detection of cardiac arrhythmias as well as vigorous treatment of predisposing conditions such as inadequate ventilation, acidosis and pain. The absence of correlation between the degree of rick, as estimated preoperatively (related to patient or procedure risk factors), and the frequency of occurrence seems to point to the value of more widespread use of ECG monitoring of pediatric patients undergoing anesthesia.

Adolescent↗
PubMed1978

Anesthesia for small animal pediatric and geriatric patients. I. Anesthesia for small animal pediatric patients.

Anesthetic management of the pediatric patient is a challenge which can give rise to a most rewarding anesthetic management if one takes into consideration the normal physiological function of the pediatric patient. One should choose the appropriate medications which may safely be administered to an animal of this age. Control of anesthesia through the use of appropriate anesthetic equipment and the use of appropriate monitoring will aid safe management. The selection of adjunct medications can achieve control of complications and aid ultimate uncomplicated recovery.

Anesthesia, General↗
PubMed1977

Ethical issues in pediatric surgery: a national survey of pediatricians and pediatric surgeons.

The findings reported in this article are based on a nationwide survey of the attitudes and practices of pediatric surgeons and pediatricians with respect to some of the difficult ethical choices confronting them in medical practice. Four hundred fifty-seven physicians completed a questionnaire in the spring of 1975 in which they reacted to a wide range of issues that have been of increasing concern to the public, as well as to the medical profession. The survey attempts to identify some areas of physician consensus as well as some of the factors, personal and professional, influencing physicians' attitudes. The survey and its statistical analysis are intended to provide current sociological data and are not intended by the authors as an endorsement of any particular point of view or course of action.

Adult↗
PubMed1992

Evaluation of CHIP (iproplatin) in recurrent pediatric malignant solid tumors. A phase II study (Pediatric Oncology Group).

CHIP (325 mg/M2), a second generation cisplatin derivative, was administered intravenously every 3 weeks to 85 pediatric patients with recurrent sarcomas (19), osteosarcomas (20), neuroblastoma (23), germ cell tumors (10), and other malignant tumors (7). Thirty-eight of them had been previously exposed to cisplatin. Partial remissions were only observed in 3 of 23 (13% SE = 7%) patients having neuroblastoma. Severe thrombocytopenia (65%) and neutropenia (35%) were the dose limiting factors.

Adolescent↗