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We examined the utility of B-type natriuretic peptide (BNP) in the evaluation of pediatric orthotopic heart transplant recipients for allograft pathology by measuring the serum BNP levels at the time of either screening echocardiography and biopsy, or at the time of clinical rejection. There was a significant difference (p <0.0001) in the BNP levels in 37(More)
For most emergency medicine physicians, the phrases "newborn workup" and "metabolic disease" are, at best, uncomfortable. This article, however, provides a simple approach to the recognition,evaluation, and treatment of infants with all manners of metabolic issues, including hypoglycemia, inborn errors of metabolism, jaundice, and electrolyte abnormalities.(More)
OBJECTIVE The goal was to identify criteria that would allow low-risk infants presenting with an apparent life-threatening event to be discharged safely from the emergency department. METHODS We completed data forms prospectively on all previously healthy patients <12 months of age presenting to the emergency department of an urban tertiary care(More)
OBJECTIVE To determine in patients who are well-appearing and without a clear etiology after an apparent life-threatening event (ALTE): (1) What historical and physical examination features suggest that a child is at risk for a future adverse event and/or serious underlying diagnosis and would, therefore, benefit from testing or hospitalization? and (2)(More)
Care of the ill and injured child requires knowledge of unique pediatric anatomic and physiologic differences. Subtleties in presentation and pathophysiologic differences impact management. This article discusses pediatric resuscitation, the presentation and management of common childhood illness, pediatric trauma, and common procedures required in the(More)
STUDY OBJECTIVE We identify factors in emergency department (ED) patients presenting with apparent life-threatening events that distinguish those safe for discharge from those warranting hospitalization. METHODS Data were prospectively collected on all subjects presenting to 4 EDs with apparent life-threatening events. Patients were observed for(More)
OBJECTIVES Suggestive radiographic studies with nonvisualization of the appendix can present a challenge to clinicians in the evaluation of pediatric abdominal pain. The primary objective of this study was to quantify the accuracy of magnetic resonance imaging (MRI) and of ultrasound (US) in the setting of nonvisualization of the appendix. Secondary(More)
OBJECTIVES Compliance with emergency department instructions regarding patient follow-up is generally poor. Children with Medicaid have been previously shown to have less access to orthopedic care than those with private insurance. Our objectives were to quantify the compliance of pediatric fracture patients with recommended emergency department follow-up(More)
We examined the patient characteristics and hospital charges associated with routine medical clearance laboratory screening tests in 1,082 children younger than age eighteen who were brought to the emergency department (ED) for involuntary mental health holds--that is, each patient was brought to the ED to be evaluated for being a danger to him- or herself(More)
BACKGROUND Although most studies have found low rates of organic illness in patients with isolated psychiatric complaints, psychiatric patients are frequently brought to emergency departments (EDs) for medical clearance. STUDY OBJECTIVES To assess the utility of ED medical clearance before transfer of pediatric patients on psychiatric holds to inpatient(More)