Nassr Nama, Amy DeLaroche, Joshua L Bonkowsky, David Gremse, Joel S Tieder
Brief resolved unexplained events (BRUEs) are frequently encountered in infants younger than 1 year. By definition, these events require the infant to be asymptomatic and at baseline at the time of presentation, with no significant abnormalities on examination and no discernible explanatory diagnosis. Research has shown that less than 5% of BRUE cases are attributable to serious underlying conditions, with no increased mortality risk and no increased risk of sudden infant death syndrome. Despite these findings, approximately 63% of patients with BRUEs are hospitalized and up to 82% undergo diagnostic tests, which predominantly result in false-positive findings. Such results may lead to unnecessarily prolonged hospital stays, additional tests or consultations, and increased parental anxiety. The management of a patient who has experienced a BRUE can be challenging for providers and parents alike. Although risk is known to be low in these infants, providers may be compelled to explain the event and provide reassurance. Caregivers oftentimes are concerned that the events may reoccur and be a harbinger of a missed diagnosis. Shared decision-making can be used to explain risk and the benefit of additional testing and hospitalization. This family-centered strategy can align care with the family's values, provide reassurance, and decrease decisional conflict.
{"title":"Brief Resolved Unexplained Event: Evidence-Based and Family-Centered Management.","authors":"Nassr Nama, Amy DeLaroche, Joshua L Bonkowsky, David Gremse, Joel S Tieder","doi":"10.1542/pir.2024-006351","DOIUrl":"https://doi.org/10.1542/pir.2024-006351","url":null,"abstract":"<p><p>Brief resolved unexplained events (BRUEs) are frequently encountered in infants younger than 1 year. By definition, these events require the infant to be asymptomatic and at baseline at the time of presentation, with no significant abnormalities on examination and no discernible explanatory diagnosis. Research has shown that less than 5% of BRUE cases are attributable to serious underlying conditions, with no increased mortality risk and no increased risk of sudden infant death syndrome. Despite these findings, approximately 63% of patients with BRUEs are hospitalized and up to 82% undergo diagnostic tests, which predominantly result in false-positive findings. Such results may lead to unnecessarily prolonged hospital stays, additional tests or consultations, and increased parental anxiety. The management of a patient who has experienced a BRUE can be challenging for providers and parents alike. Although risk is known to be low in these infants, providers may be compelled to explain the event and provide reassurance. Caregivers oftentimes are concerned that the events may reoccur and be a harbinger of a missed diagnosis. Shared decision-making can be used to explain risk and the benefit of additional testing and hospitalization. This family-centered strategy can align care with the family's values, provide reassurance, and decrease decisional conflict.</p>","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"560-572"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case 1: A Neonate Presenting in Shock.","authors":"Pezad N Doctor, Claudio Ramaciotti, Munes Fares","doi":"10.1542/pir.2022-005953","DOIUrl":"https://doi.org/10.1542/pir.2022-005953","url":null,"abstract":"","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"573-576"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Mouthful: Recurrent Oropharyngeal Bleeding in a Child.","authors":"Lauren Chan, Maya Neeley, Amy Whigham, Ryan Wolf","doi":"10.1542/pir.2022-005929","DOIUrl":"10.1542/pir.2022-005929","url":null,"abstract":"","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"597-600"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute-Onset Elbow Pain in a 14-year-old Football Quarterback.","authors":"Don Sim, Aaron Watters","doi":"10.1542/pir.2022-005872","DOIUrl":"https://doi.org/10.1542/pir.2022-005872","url":null,"abstract":"","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"594-596"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Umbilical Discharge in a 3-week-old Boy.","authors":"Jessica Tao, Carsten Krueger, Charles Hui","doi":"10.1542/pir.2022-005828","DOIUrl":"10.1542/pir.2022-005828","url":null,"abstract":"","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"590-593"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mathew Hakimi, Alicia M Kamsheh, Matthew J O'Connor, Steven Loscalzo
{"title":"Case 3: Shock after Gluteal Abscess Incision and Drainage in a 15-month-old Girl.","authors":"Mathew Hakimi, Alicia M Kamsheh, Matthew J O'Connor, Steven Loscalzo","doi":"10.1542/pir.2023-006019","DOIUrl":"10.1542/pir.2023-006019","url":null,"abstract":"","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline V Jackson, Katelyn M Banschbach, Stephen C Wong, Shina Menon
{"title":"Recent Diagnosis of Lupus and Severe Hypertriglyceridemia in a 12-year-old Girl.","authors":"Caroline V Jackson, Katelyn M Banschbach, Stephen C Wong, Shina Menon","doi":"10.1542/pir.2022-005930","DOIUrl":"10.1542/pir.2022-005930","url":null,"abstract":"","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"601-605"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Newborn with a Purpuric Rash.","authors":"Caitlin Grace, Daniel Kahn, Scott Duncan","doi":"10.1542/pir.2023-006117","DOIUrl":"https://doi.org/10.1542/pir.2023-006117","url":null,"abstract":"","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"e38-e40"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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