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Biomedical subjects

B Taubman

Publications and source records attributed to B Taubman.

13 recordsLinked to original sources
PubMed1997

Overflow encopresis and stool toileting refusal during toilet training: a prospective study on the effect of therapeutic efficacy.

We determined the incidence of stool toileting refusal in 53 children with overflow encopresis; 24 (45%) experienced difficulty toilet training for bowel movements. One-year follow-up data were obtained for 43 children, 31 with secondary encopresis and 12 with primary encopresis. Among the children with secondary encopresis, no difference was observed in response to treatment between children with and without difficulty toilet training. Ninety-one percent (11 of 12) of the children who had been soiling for less than 1 year at the time of presentation were free of soiling and no longer required therapeutic medication, compared with 55% (10 of 18) of the children who had been soiling for a longer period. Only 1 of 12 children with primary encopresis was free of soiling and no longer receiving therapeutic medication at 1 year, compared with 21 of 37 with secondary encopresis (p = 0.003). We concluded that children with primary encopresis who demonstrated stool toileting refusal during toilet training were resistant to medical treatment.

Adolescent↗
PubMed1997

Behavioral characteristics of children with stool toileting refusal.

OBJECTIVE: To determine if children with stool toileting refusal have more behavior problems than matched children who are toilet trained. DESIGN: Case-control study. SETTING: Suburban private pediatric practice. PARTICIPANTS: Children 30 to 48 months old who had achieved bladder control but refused to defecate on the toilet were identified as cases. Controls were sex- and age-matched children who were fully toilet trained. MEASURES: Total behavior problems were assessed using a semi-structured behavior screening interview with the child's parents. The parents also completed the Child Behavior Checklist for ages 2 to 4 and either the Toddler Temperament Scale (30 to 36 months old) or the Behavioral Style Questionnaire (36 to 48 months old). Child compliance with adult instructions was measured during a room clean-up task. RESULTS: Children with stool toileting refusal were not found to have more behavior problems than the matched children who were toilet trained. There were no differences between the two groups in compliance during the room clean-up task. There was a trend toward children with stool toileting refusal having a more difficult temperament, and these children were reported to have more problems with constipation and painful bowel movements than the controls. CONCLUSIONS: Children with stool toileting refusal do not have more behavior problems than controls who are toilet trained. Parents do report higher rates of constipation and painful defecation, but it is not clear whether this is a cause or effect of stool toileting refusal.

Case-Control Studies↗
PubMed1997

Toilet training and toileting refusal for stool only: a prospective study.

OBJECTIVE: To determine the incidence of toileting refusal for bowel movements and its outcome when toilet training children using a child-oriented approach. DESIGN: Prospective study. SETTING: Private suburban pediatric setting consisting of middle and upper middle class families. METHODS: Healthy children between 18 and 30 months with no signs of developmental delay were enrolled in the study. Parents were given questions regarding their child's toilet training and behavior. Families were followed every 6 months during an office visit or by phone call until the child was successfully day time toilet trained. RESULTS: A total of 482 children (255 males) completed the study. There were 106 children (54 males) (22%) who experienced at least 1 month of stool toileting refusal. There was an association between the presence of younger siblings (P = .023) and parental inability to set limits for the child (P = .017) and stool toileting refusal. Stool toileting refusers trained at a later age than the rest of the group (P < .0001). Fifty percent (22/44) of the children who trained between 42 and 48 months and 73% (8/11) of the children who trained after 48 months experienced stool toileting refusal. Sixty-one of the study children developed stool withholding during toilet training. Forty-nine (80%) of these children were stool toileting refusers (P < .00001). In 77 (73%) of the children no intervention was undertaken. Of these, the behavior lasted more than 6 months in 20. Intervention was undertaken with 29 children, either because of severe stool withholding (23) or the age of the child (6). Interupting toilet training and having the child return to diapers resulted in the child spontaneously using the toilet for bowel movements within 3 months in 24 of 27 children. CONCLUSION: Stool toileting refusal occurred in one in five children in this study population. Two behaviors associated with stool toileting refusal may require the intervention of the pediatrician. The first is stool withholding causing constipation which can result in rectal impaction and primary encopresis. The second is lack of successful toilet training by 42 months of age. A child who is still untrained at this late age can be a source of family conflict and stress requiring the advice and support of the pediatrician.

Behavior Therapy↗
PubMed1996

Slipping rib syndrome as a cause of chest pain in children.

Four patients with the slipping rib syndrome presenting as chest pain are described, and the appropriate literature is reviewed. In two of the patients the physicians caring for the children were initially concerned that a cardiac condition was the cause of the chest pain, and a cardiac evaluation was done. In one patient an emotional cause for the pain was first considered and then a cardiac cause was pursued. In the last patient esophagitis was thought to be the cause and the child was referred to a gastroenterologist. It is suggested that slipping rib syndrome should be considered by physicians when evaluating children with a complaint of chest pain. The condition can be easily diagnosed on physical examination and therefore may save some patients from an unnecessary cardiac or gastroentestinal evaluation.

Adolescent↗
PubMed1989

The diagnosis of group A, beta-hemolytic streptococcal pharyngitis in the office setting. Rapid latex test vs throat culture.

We compared a rapid latex agglutination test with cultures of throat specimens to diagnose group A beta-hemolytic streptococcal pharyngitis in an office setting. The throat cultures were interpreted by two pediatricians independently and evaluated by a reference laboratory. Five hundred seventy-two children participated in the study. The latex agglutination test had a sensitivity of 89.4% and a specificity of 85.7%. Cultures of throat specimens obtained in the office had a sensitivity of 91.9% and a specificity of 91.7% when interpreted by investigator 1, and a sensitivity of 90.0% and a specificity of 95.1% when interpreted by investigator 2. There was no statistically significant difference between the numbers of false-negative results generated by the two procedures. We conclude that although somewhat less specific, the latex test is as sensitive as cultures of throat specimens in the office setting.

Adolescent↗
PubMed1989

Changes in preobesity weight velocities in obese children.

A retrospective analysis of the growth charts of 58 (30 females, 28 males) obese children from the author's general pediatric practice was undertaken to determine changes in preobesity weight velocity. The children fell into two groups. One group of children (group 1, n = 30) had a small increase (0.36 +/- 0.49, means +/- SD) in their weight velocity Z scores the year before reaching obesity. The second group (group 2, n = 28) had an increase (2.42 +/- 1.0) in their weight velocity Z scores more than six times that of the first group. There was no significant difference between the two groups in terms of severity of obesity either at onset. By later, or at adolescence. Nor was there a significant difference in age of onset of obesity, presence of obesity in their parents, or the persistence of obesity into adolescence.

Adolescent↗
PubMed1988

Parental counseling compared with elimination of cow's milk or soy milk protein for the treatment of infant colic syndrome: a randomized trial.

Treating the infant colic syndrome by counseling the parents concerning more effective responses to the infant crying is compared to the elimination of soy or cow's milk protein from the infant's diet in a randomized clinical trial. Because symptoms of vomiting and diarrhea are not part of the infant colic syndrome, infants with these gastrointestinal symptoms were excluded from the study. Dietary changes were accomplished by either feeding the infants a hydrolyzed casein formula or by requiring mothers to eliminate milk from their diets. In phase 1 of the study, the group receiving counseling (n = 10) had a decrease in crying from 3.21 +/- 1.10 h/d to 1.08 +/- 0.70 h/d (P = .001). The crying in the group that received dietary changes (n = 10) decreased from 3.19 +/- 0.69 h/d to 2.03 +/- 1.07 h/d (P = .01), a level still greater than twice normal. The decrease in those receiving counseling was faster and greater than that of those given dietary changes (P less than .02). In the second phase of the study, group 2 infants were reexposed to cow's milk or soy protein and the parents received counseling. In this phase, counseling again decreased crying significantly from 2.09 +/- 1.07 h/d to 1.19 +/- 0.60 h/d (P = .05). No infant in the study who improved with changes in his or her diet had a significant increase in crying, with reexposure to soy or cow's milk protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Familial Reye-like syndrome: a presentation of medium-chain acyl-coenzyme A dehydrogenase deficiency.

A 20-month-old girl with a family history of two siblings who died of an encephalopathy diagnosed as Reye syndrome presented to an emergency room in hypoglycemic coma and was found to have medium-chain acyl-coenzyme A dehydrogenase deficiency. The salient clinical and biochemical features of this newly described inborn error of fatty acid metabolism are described and contrasted to those of classical Reye syndrome. Important clues that should lead the clinician to suspect this disorder, methods of diagnosis, and appropriate acute and long-term therapy are also discussed.

Acyl-CoA Dehydrogenase↗
PubMed1984

Clinical trial of the treatment of colic by modification of parent-infant interaction.

A study evaluating the treatment of colic by modification of the parent-infant interaction was carried out in a private practice setting. The study population consisted of 30 normal colicky infants and 30 control infants matched for age in weeks, sex, and the presence of siblings. The two groups were similar with regard to sociodemographic and other variables with the exception that mothers of colicky infants were older (P less than .005). Quantitative measurements of crying were obtained using prospective diaries of infant behavior. Colicky infants were found to cry 2.6 +/- 1.1 h/d as compared with 1.0 +/- 0.5 h/d for control infants (P less than .001). The treatment of these infants was based on the assumption that colic results from inappropriate parental responses to the baby's crying and consisted of counseling the parent on more effective responses. This resulted in the infants' crying decreasing from 2.6 +/- 1.1 h/d to 0.8 +/- 0.3 h/d (P less than .001), no different from the average of the control group. It is concluded that a major cause of colic is the misinterpretation of infant cries leading to ineffective responses, and that this can be managed by counseling parents on how to respond to infant crying.

Clinical Trials as Topic↗