@article {10864, title = {Red Flags in Torticollis: A Historical Cohort Study.}, journal = {Pediatr Emerg Care}, volume = {34}, year = {2018}, month = {2018 Jul}, pages = {463-466}, abstract = {

OBJECTIVE: This study aimed to assess the spectrum of pathologies responsible for torticollis in children presenting to the emergency department and to evaluate the associated symptoms to determine clinical red flags for hospitalization.

METHODS: This was a historical retrospective cohort study. Medical records of children evaluated in our emergency department for torticollis from 2008 to 2013 were reviewed.

RESULTS: Among 392 identified patients, 61\% had postural torticollis,19.4\% infection related, 16.3\% traumatic, and 3.5\% other. Twenty-five patients (6.4\%) were hospitalized. Four variables were strongly and independently related to the severe outcome: fever, sore throat, headache, and age.

CONCLUSIONS: The association of 2 or 3 of these 4 features carried a risk of 32\% and 58\%, respectively, of having a severe illness.

}, keywords = {Adolescent, Child, Child, Preschool, Cohort Studies, Emergency Service, Hospital, Female, Hospitalization, Humans, Male, Retrospective Studies, Torticollis}, issn = {1535-1815}, doi = {10.1097/PEC.0000000000001377}, author = {Starc, Meta and Norbedo, Stefania and Tubaro, Martina and Ronfani, Luca and Bassanese, Giulia and Barbi, Egidio} } @article {1887, title = {Sedation with intranasal midazolam of Angolan children undergoing invasive procedures.}, journal = {Acta Paediatr}, volume = {101}, year = {2012}, month = {2012 Jul}, pages = {e296-8}, abstract = {

AIM: Ambulatory surgery is a daily requirement in poor countries, and limited means and insufficient trained staff lead to the lack of attention to the patient{\textquoteright}s pain. Midazolam is a rapid-onset, short-acting benzodiazepine which is used safely to reduce pain in children. We evaluated the practicability of intranasal midazolam sedation in a suburban hospital in Luanda (Angola), during the surgical procedures.

METHODS: Intranasal midazolam solution was administered at a dose of 0.5 mg/kg. Using the Ramsay{\textquoteright}s reactivity score, we gave a score to four different types of children{\textquoteright}s behaviour: moaning, shouting, crying and struggling, and the surgeon evaluated the ease of completing the surgical procedure using scores from 0 (very easy) to 3 (managing with difficulty).

RESULTS: Eighty children (median age, 3 years) were recruited, and 140 surgical procedures were performed. Fifty-two children were treated with midazolam during 85 procedures, and 28 children were not treated during 55 procedures. We found a significant difference between the two groups on the shouting, crying and struggling parameters (p < 0.001). The mean score of the ease of completing the procedures was significantly different among the two groups (p < 0.0001).

CONCLUSION: These results provide a model of procedural sedation in ambulatory surgical procedures in poor countries, thus abolishing pain and making the surgeon{\textquoteright}s job easier.

}, keywords = {Administration, Intranasal, Adolescent, Ambulatory Surgical Procedures, Angola, Child, Child Behavior, Child, Preschool, Conscious Sedation, Crying, Female, Humans, Hypnotics and Sedatives, Infant, Male, Midazolam, Prospective Studies}, issn = {1651-2227}, doi = {10.1111/j.1651-2227.2012.02691.x}, author = {Kawanda, Lumana and Capobianco, Ivan and Starc, Meta and Felipe, Daniel and Zanon, Davide and Barbi, Egidio and Munkela, Nadine and Rodrigues, Ver{\'o}nica and Malundo, L{\'u}is and Not, Tarcisio} }