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1.
Hawaii J Health Soc Welf ; 83(10): 274-278, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39371581

ABSTRACT

A 2-year-old boy tested positive for SARS-CoV-2 and, after 30 days of mild-moderate respiratory symptoms, suddenly deteriorated and required extracorporeal membrane oxygenation. Lung biopsy was performed with findings consistent with organizing pneumonia. He received intensive therapy with high-dose methylprednisolone, intravenous immune globulin, rituximab, and plasmapheresis without improvement. He died after 85 days hospitalization. This case highlights unique presentations of COVID-19 and reaffirms the concept that, while rare in Hawai'i, pediatric COVID-19 is an ongoing problem and that severe, even fatal, disease can occur.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/complications , Male , Child, Preschool , Fatal Outcome , Hawaii , Methylprednisolone/therapeutic use , Extracorporeal Membrane Oxygenation/methods , Organizing Pneumonia
3.
Ochsner J ; 13(3): 375-9, 2013.
Article in English | MEDLINE | ID: mdl-24052767

ABSTRACT

BACKGROUND: Tobacco use is the world's leading single preventable cause of death. Because children exposed to second- and third-hand smoke are at risk for smoke-related morbidity, pediatricians have an obligation to address tobacco use in their practices. The purpose of this study was to measure physician adherence to the American Academy of Pediatrics' guidelines on tobacco prevention, control, and treatment before and after the implementation of an educational outreach program. METHODS: Charts were randomly selected from pediatric clinics before and after the educational outreach. The intervention consisted of a review of the guidelines and available tools physicians could implement into their practices. We measured the rates of adherence to the guidelines before and after the educational outreach. RESULTS: We analyzed 213 charts (116 pre- and 97 posteducation). The proportion of families screened for tobacco smoke exposure was comparable between the pre- and postintervention groups (67.2% vs 59.8%, P=0.317). The postintervention group had a higher proportion of counseling compared to the preintervention group (51.5% vs 31.9%, P<0.05). We found no statistically significant change in the rate of screening or referral to smoking cessation services. CONCLUSION: Current guidelines to reduce tobacco use are underutilized. Educational outreach may increase the rate of counseling. Physician acceptance of guidelines is urgently needed to affect the tobacco epidemic.

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