Severe diarrheal illness in children can be attributed to a number of different microbiological agents. Without appropriate microbiological testing of stool samples, patients who present with multiple days of severe diarrhea might have a delay in proper diagnosis and treatment. Here, we report a case of an immunocompetent pediatric patient presenting with acute cryptosporidiosis. Humans and bovine species are known hosts of cryptosporidium and several studies have evaluated the zoonotic transmission of cryptosporidium from cattle to humans. Adding diagnostic tests for cryptosporidium like Ziehl-Neelsen staining of stool or fecal rapid antigen detection techniques should be considered in the workup of patients presenting with undifferentiated, severe diarrheal illness, especially in those who have close contact with livestock.
HighlightsPneumoperitoneum may not always be an ominous sign in the pediatric population.Cases of non-surgical pneumoperitoneum in the pediatric population are scarce.The clinical picture of a patient should be the primary determinant of management.Conservative measures can be used in pediatrics with isolated pneumoperitoneum.If the diagnosis is still unclear, clinical correlation should take precedence.
Background:A qualitative assessment of the research used in the development of a widely used Clinical Practice Guideline (CPG) to gain insight into the kinds of evidence that informs the development of CPGs. Methods: All articles cited within the 2003 Canadian Pediatric Asthma Consensus Guideline ("the Guideline") were secured, as was the literature cited by these articles. Two independent reviewers coded all 98 articles referenced by the Guideline ("primary citations"), and the 3,167 articles referenced by the primary citations ("secondary citations"), along three schemes: article type, research design and article orientation. Results: Among the primary and secondary citations Clinical research was the most represented type (53%), followed by Health Services (25%), Population Health (18%), and Biomedical (4%). There was a strong interdependence between Clinical and Health Services Research articles with each type frequently citing the other. Observational study designs were most common (48%), followed by experimental studies (31%) and secondary research (21%). Discussion: While CPGs rely on significant support from clinical or biomedical randomized controlled trials, the translation of research into practice is non-linear with an important role for Health Services Research and Population Health. This may have implications for funding agencies and other supporters of health research who are working to bridge the gap between research and clinical practice.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.