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Biomedical subjects

D Hodge

Publications and source records attributed to D Hodge.

54 records · Page 3Linked to original sources
PubMed1990

Proliferating cell nuclear antigen expression in childhood acute leukemia.

Proliferating cell nuclear antigen (PCNA) is a 36-Kd nuclear protein, identified as the auxiliary protein of DNA polymerase delta, that is upregulated in activated proliferating cells from a variety of tissues and species, including human lymphocytes. We have examined by two-dimensional polyacrylamide gel electrophoresis the expression of PCNA in various subtypes of childhood acute leukemia and have found differences in its expression according to subtype. These differences were not related to the initial peripheral white blood count, age, or sex, and appeared to reflect differences in proliferative activity between subtypes of acute leukemia.

Acute Disease↗
PubMed1990

Equipping and preparing the office for emergencies.

It is the practitioner's responsibility to have a prepared office to aid the emergently ill child. Basic equipment and staff training are essential. The pediatrician and family practitioner are on the front lines of pediatric emergency care and, with minimal equipment and training, can serve a vital role in the initial stabilization of the critically ill child.

Child↗
PubMed1987

Intraosseous infusion flow rates in hypovolemic "pediatric" dogs.

We tested a 20-gauge, 2 1/2-inch spinal needle and a 13-gauge, 3 1/2-inch bone marrow needle with Ringer's lactate delivered by gravity and 300 mm Hg pressure in vitro and in hypovolemic puppies to ascertain in vivo intraosseous flow rates and to determine the effects of catheter size and anatomic factors on flow rate. In vitro flow was significantly faster than in vivo flow (P = .001). In vivo, mean flow rates were 11 mL/min for the 20-gauge needle and 13 mL/min for the 13-gauge needle by gravity. The mean flows by 300 mm Hg pressure for the same needles were 24 mL/min and 29 mL/min. While the in vivo flow rates were significantly greater for the 13-gauge versus the 20-gauge needle, the differences were not clinically significant (2 mL/min difference by gravity and 5 mL/min difference by pressure). The clinically comparable in vivo rates for the two needles tested indicated that the rates are dependent on flow through the bone marrow rather than the size of the needle. The data suggest that while intraosseous infusion is a rapid technique for gaining vascular access, the flow rates achieved may not be sufficient for the definitive treatment of severe hypovolemic or hemorrhagic shock alone.

Animals↗
PubMed1987

Laboratory and clinical evaluation of isolation media for Campylobacter jejuni.

Six selective isolation media were evaluated for their ability to support the growth of Campylobacter jejuni. Colony counts of 70 isolated strains of C. jejuni and recovery studies on these strains in simulated positive feces samples demonstrated that Bolton and Hutchinson' charcoal, cefoperazone, deoxycholate agar and Karmali's charcoal-based selective medium produced the highest recovery rates with the greatest suppression of other fecal flora. C. jejuni colonies were more easily recognized on charcoal-based selective medium. A clinical evaluation performed on 2,780 human, animal, and avian feces specimens confirmed the results of the laboratory investigation. From human samples, 4 more strains of C. jejuni were isolated on charcoal-based selective medium than were isolated on Skirrow medium, and 19 more strains of C. jejuni or C. coli were isolated on charcoal-based selective medium from animal specimens. Suppression of normal fecal flora was also greater on charcoal-based selective medium.

Animals↗
PubMed1986

Central and peripheral catheter flow rates in "pediatric" dogs.

Several authors have reported flow rates for various catheters in vitro, but these studies may not reflect differences in vivo because of intravascular pressure, valves, and/or venous tortuosity, particularly in the small vessels of the child. We studied flow rates of four small-gauge catheters in a "pediatric" dog model. We found that flow rates were less in vivo than in vitro, less in peripheral than in central veins, and equal in hypovolemic and normovolemic dogs. Our data indicate that the results of in vitro studies cannot be extrapolated directly to predict achievable flow rates in clinical practice. In particular, a small-diameter catheter in the central circulation may allow delivery of fluid under pressure at a faster rate than does a catheter of larger diameter in a peripheral vein. Thus decisions about site, type, and size of catheter for fluid resuscitation should be based on data obtained in vivo.

Animals↗
PubMed1985

Pediatric catheter flow rates.

The flow rates of the 18- to 24-gauge catheters most commonly used in pediatrics were studied to determine which catheters and infusion techniques allowed for rapid volume replacement in infants and children. As expected, short, large-diameter catheters were found to have a higher flow rate, and flows under pressure in the largest catheters tested were up to 17 times greater than in a longer, smaller diameter catheter. Catheters designed for peripheral venous insertion in children showed an 18 to 164% increase in flow rate when compared with the same gauge catheters designed for central venous use. Thus, intravenous access via a central vein does not guarantee more rapid fluid infusion unless the use of the central vein permits the insertion of a catheter larger in diameter than any that could be placed peripherally. Knowledge of the flow rates determined for the various catheters in this study will assist the physician in optimizing fluid resuscitation of the critically ill or injured child.

Blood Transfusion↗
PubMed1985

Coin ingestion: does every child need a radiograph?

We studied 80 children who presented to the emergency department (ED) with a complaint of coin ingestion to determine whether radiographs are necessary in all situations and to determine which symptoms or signs are predictive of esophageal coins. Radiographs were considered positive if the coin was in the esophagus. Radiographs were positive in 25 (31%) of patients, of whom 11 (14%) had no symptoms or signs in the ED. Fifty-five (69%) of the 80 patients had subdiaphragmatic foreign bodies (44 [55%]), or no foreign bodies (11 [14%]) seen on films. Fourteen (18%) of the children required removal of the coin. Variables correlating with positive radiograph, in order of significance, included localization, choking at ingestion, drooling in the ED, vomiting, and chest pain (P less than .05). Symptom type was predictive of radiographic findings, and it may be predictive of need for removal. All 14 patients with symptoms or signs in the ED had positive films, as compared to 11 of 66 (16.6%) with no symptoms (chi square = 33.555; P less than .001). Although this relationship is significant, the finding of esophageal foreign body in 17% of patients with no symptoms leads us to recommend that all patients have a chest radiograph if coin ingestion is suspected.

Child↗
PubMed1985

Antibiotic susceptibility of blood and cerebrospinal fluid isolates of Haemophilus influenzae.

One hundred and sixty-nine blood and cerebrospinal fluid isolates of Haemophilus influenzae, collected in the Province of Ontario from children and adults from 1976 to 1983, were tested for susceptibility to six conventional and eight newer antibacterial drugs. Most active were ceftriaxone, ceftizoxime and cefotaxime (MIC90 less than or equal to 0.02 mg/l); latamoxef (moxalactam), acrosoxacin and ceftazidime were close behind with MIC90s in the 0.05-0.09 mg/l range. Twenty-five strains (14.8%) were beta-lactamase-producing and thus resistant to ampicillin. There were no chloramphenicol-resistant strains. The isolates showed intermediate but still clinically useful susceptibility to trimethoprim, rifampicin, cefuroxime, piperacillin and chloramphenicol and were least susceptible to gentamicin and sulphamethoxazole.

Adult↗
PubMed1985

Child homicide: emergency department recognition.

Homicide is escalating as a cause of sudden death in childhood. With the ever-rising rate of child abuse in the United States, the emergency physician is increasingly likely to encounter cases of attempted homicide. In order to improve survival in such cases, the emergency department (ED) staff must be alert to the subtle signs and symptoms of this form of trauma and be prepared to institute life-saving therapy. We reviewed 12 cases of child homicide seen in our ED between 1981 and 1983 and summarized the findings on these unfortunate children. The typical victim was a young child in the second half of the first year or in the second year of life. The most common forms of fatal injury were CNS injury and abdominal trauma. In both types of injuries, there were often subtle findings on external physical examination. It was important for the physician to have a high index of suspicion based on a protean chief complaint, a lack of preceding history of illness, the time of presentation to the ED, and more subtle physical findings such as minor skin bruising, retinal hemorrhage, and distended abdomen. A low hematocrit was also suggestive of traumatic cause for the child's critical state. In addition, autopsy findings for the 12 patients are presented.

Autopsy↗
PubMed1985

Intraosseous infusions: a review.

Intravenous access is critical in infants and children with severe shock or cardiac arrest. However, it is in these clinic situations that venous access may be most difficult. The technique of intraosseous infusion may provide a useful alternative to intravenous access in the initial phases of resuscitation. The method of insertion, indications, contraindications, and complications are reviewed.

Adult↗
PubMed1982

The bacteriologically battered baby: another case of Munchausen by proxy.

We present a case in which a mother who had had self-inflicted infections as a teenager also caused life-threatening infections in her year-old child. After testing for and treating various immunologic deficiencies without success, it was apparent that the infection was caused by contamination of intravenous sites. Strict isolation of the patient, with restricted and observed visitations by the mother, was the critical step in stopping the infections. Because the woman took her child to several emergency departments, this case is presented to alert emergency personnel to this entity and to explain some of the dynamics and the social issues that cause the problem.

Adult↗
PubMed1980

Penile edema in childhood gonorrhea.

A two-year-old boy with painless penile edema was seen in our emergency department. No discharge was present initially, but palpation of the urethra expressed a drop of material from the meatus. Neisseria gonorrhoeae was isolated, and the edema resolved rapidly following penicillin treatment. This report provides, to out knowledge, the first description of penile venereal edema in a child and discusses the diagnostic considerations in penile swelling.

Child, Preschool↗