Biomedical subjects
C R Baum
Publications and source records attributed to C R Baum.
Toxicology reviews: immunoassay in detecting drugs of abuse.
Ingestion of DOA by children and adolescents continues to be a prevalent problem. Emergency physicians, particularly those in pediatric institutions, should have an understanding of the screening tests for DOA. Several IA techniques provide a rapid, sensitive, and inexpensive screen for DOA. Nevertheless, the physician must be familiar with the limitations of each laboratory and be aware that a negative toxicology screen does not rule out ingestion of many DOA.
Breath and blood ethanol following use of a cough-cold preparation.
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The lead concentration of reconstituted infant formula.
OBJECTIVE: To characterize practices of infant formula reconstitution and to measure the lead concentration of the home-prepared reconstituted infant formula. METHODS: Convenience sample of metropolitan Boston infants less than 9 months of age who were being evaluated in an urban pediatric emergency department and had home-prepared reconstituted infant formula available. A questionnaire was administered to gather demographic information and details of formula preparation. A 30-90 mL sample of home-prepared reconstituted infant formula was collected in an acid-washed, distilled water-rinsed glass tube, then analyzed for lead by atomic absorption spectrophotometry (precision +/- 2 micrograms/L or 2 ppb). RESULTS: Forty infants were evaluated. Mean (SD) chronological age was 112 +/- 78 d. Reported daily reconstituted infant formula daily volume was 870 +/- 300 mL. Two of the 40 samples (5% [95% CI: 2.0, 18.2%]) had lead concentrations above 15 micrograms/L, the current action level for safe water according to the Environmental Protection Agency. The two samples with lead concentrations of 17 and 70 micrograms/L were prepared using cold tap water (water run for 5 and 30 sec, respectively) drawn from the plumbing of houses greater than 20 years old. CONCLUSION: These data suggest that the use of infant formulas which require reconstitution may present inadvertent lead hazards to young infants. Pediatricians should provide education about these potentially hazardous practices to parents who use these formulas.
Accidental administration of an ergot alkaloid to a neonate.
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What do physicians in practice do to prevent osteoporosis?
Osteoporosis-associated fractures are a major public health problem in the United States. Although clinicians and policy groups have advocated estrogen replacement therapy and other clinical measures to prevent osteoporosis, few studies have assessed whether these measures are being adopted by physicians in practice. The purpose of this study is to evaluate physicians' use of osteoporosis prevention measures and to assess the impact of physician specialty and practice setting on osteoporosis prevention performance. A survey of nearly 300 physicians was carried out in a large metropolitan area. Gynecologists, general internists, and cardiopulmonary specialists were included from one of three practice settings: fee-for-service private practice, full-time academic medicine, or a large health maintenance organization. Most physicians, regardless of clinical specialty or practice setting, report that they advocate exercise and calcium supplementation. Few physicians prescribe estrogen replacement therapy (ERT) for the majority of their postmenopausal patients. Although there are minimal differences among the three types of practice settings examined, ERT varies markedly by clinical specialty. Of the gynecologists surveyed, 37% report prescribing ERT for the majority of their postmenopausal patients to prevent osteoporosis compared to only 7 and 5% of general internists and cardiopulmonary specialists, respectively (chi 2 = 45.3, p less than 0.0001). Although the efficacy of exercise and calcium supplementation to prevent osteoporotic fractures has not been well established, these measures are commonly advocated by both generalists and subspecialists. Although gynecologists are significantly more likely to prescribe ERT to prevent osteoporosis than the other clinical specialists, in general very few physicians prescribe ERT for most postmenopausal patients.(ABSTRACT TRUNCATED AT 250 WORDS)