Clinical Pediatrics最新文献

Parents of infants requiring neonatal intensive care unit (NICU) hospitalization often experience increased rates of distress, trauma, and perinatal mood disorders. Untreated parental mental health conditions have short- and long-term effects for infants and families. While some NICUs provide varying degrees of mental health supports for NICU families, these services are not universally or systematically integrated in US NICUs. Multiple factors contribute to this gap in care, including mental health stigma, funding constraints, and lack of staff training and capacity. In an effort to address this gap, we used a participatory action research approach, guided by a Patient and Stakeholder Engagement model, to partner with graduate NICU parents and patient-facing NICU staff to identify parental mental health needs and ideas to address them. Through efforts to mitigate power differentials and engage parents as research and program development partners, our work shaped NICU practices, programming, and subsequent research.

Background: It is necessary to evaluate the risk factors of secondary bleeding after tonsillectomy in children, to provide reference for clinical children management and care.

Methods: Children who underwent tonsillectomy from January 1, 2018, to December 31, 2022, in our hospital were retrospectively included. The characteristics of children with and without secondary bleeding were analyzed.

Results: A total of 1068 children undergoing tonsillectomy were included, and the incidence of secondary bleeding children undergoing tonsillectomy was 4.87%. Age ≥ 9 years old (odds ratio [OR] = 2.609, 95% confidence interval [CI] = 2.112-3.437), type of surgery (OR = 1.764, 95% CI = 1.148-2.291), and degree of tonsil embedding (OR = 2.116, 95% CI = 1.805-2.644) were the risk factors of secondary bleeding after tonsillectomy in children (all P < .05).

Conclusion: Medical staff should proactively monitor and address the identified risk factors by implementing timely warning systems and preventive strategies to reduce the postoperative bleeding following tonsillectomy.

Penicillin allergy knowledge has not been evaluated specifically in the pediatric resident population. An anonymous electronic survey was distributed to all the pediatric residents in a single residency program to ascertain knowledge of penicillin allergies and allergy history taking skills. Responses among each resident class were compared using the Fisher exact test, 2-tailed. A total of 46 (52%) of 88 pediatric residents completed the survey. Only 63% reported to have had prior penicillin allergy education. All residents incorrectly identified low-risk symptoms as high-risk symptoms. The knowledge of penicillin allergy was poor across all training levels with no improvement over the duration of training. There is large support in the literature for de-labeling penicillin allergy in patients. Pediatric residents evaluate patients in childhood when most of the allergy labeling occurs. We need to consider strategies for incorporating penicillin allergy education in pediatric residency training.

Adolescent sexual health documentation reflects the depth of discussion physicians conduct with their patients. Limited studies exist on rates of sexual history documentation in technology-dependent patients. We sought to identify whether treatment gaps exist in a technology-dependent adolescent population. Well-child visits for patients with enterotomy or tracheostomy dependence, 12 to 19 years age, and seen in our urban clinic over a 3-year period (n = 14) were compared with a randomly selected peer group without technology dependence. Documentation of sexual activity, sexual orientation, safe sex and sexually transmitted infection (STI) guidance, and contraception or condom use were noted. Results demonstrate lower rates of documentation in sexual orientation, safe sex and STI guidance, and contraception or condom use in patients with technology dependence when compared with patients without technology dependence. Similar differences were noted in the 16- to 19-year group between the experimental and control groups. No differences were noted between gender and age groups.