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Biomedical subjects

E M Friedman

Publications and source records attributed to E M Friedman.

At least 55 records · Page 3Linked to original sources
PubMed1990

Chronic pediatric stridor: etiology and outcome.

Stridor in children is usually acute. This paper represents a chart review and telephone survey of 60 patients with chronic pediatric stridor. The most common etiology was laryngomalacia, which required airway intervention in 22% of the patients. The symptoms persisted beyond 18 months of age in 17% of the patients. Twelve percent of the patients had multiple lesions; 65% of the second lesions were below the vocal cords. It appears that the presence of cyanosis should increase physician suspicion of multiple lesions. There was not a higher risk of recurrent upper respiratory infections with any of the diagnoses.

Child, Preschool↗
PubMed1989

Caustic ingestions and foreign bodies in the aerodigestive tract of children.

Caustic ingestions, both accidental and intentional, continue to cause significant morbidity and mortality. This article recommends the best methods of managing caustic ingestion and the related problems of foreign bodies in the digestive tracts of small children, and also stresses the need for prevention as the best defense.

Burns, Chemical↗
PubMed1987

Melanotic neuroectodermal tumor of infancy.

A case of melanotic neuroectodermal tumor of infancy has been presented, and the etiology, clinical presentation, and management of this rare tumor have been discussed. The tumor may not be familiar to most otolaryngologists and should be included in the differential diagnosis of pediatric head and neck neoplasms.

Female↗
PubMed1987

Computed tomography in the evaluation of choanal atresia in infants and children.

While traditional confirmatory clinical tests are helpful in establishing the diagnosis of choanal atresia, they give little useful information concerning the composition, position, and thickness of the atresia plate. Surgeons experienced in the repair of choanal atresia have recognized that detailed anatomic assessment is valuable in the preoperative selection of the method of repair and design of the repair once undertaken. The utilization of high-resolution computerized tomography to provide such information in a group of infants and children with choanal atresia forms the basis for this report. The application of computed tomography in the evaluation of choanal atresia and preoperative surgical planning is discussed. Based on this experience, we feel that the introduction of high-resolution computerized tomography is a significant advance in the diagnostic and therapeutic approach to choanal atresia and should be the single radiographic procedure of choice.

Child↗
PubMed1985

Bacterial tracheitis--two-year experience.

Inflammatory illnesses of the pediatric airway cause significant morbidity and mortality. Bacterial tracheitis is a distinct entity with features common to both croup and epiglottitis. Ten patients between the ages of 3 months and 12 years were treated at Children's Hospital, Boston, MA., for bacterial tracheitis. The clinical presentation and medical management is discussed. Seven of the patients required both direct laryngoscopy and bronchoscopy; one patient required urgent intubation; and one patient required indirect laryngoscopy. In one patient the diagnosis was based on clinical and radiographic findings in conjunction with tracheal aspirates. Seven of the 10 patients did well with aggressive medical management. Three patients required endotracheal intubation. No patient required tracheotomy, and there were no cardiopulmonary arrests. It is of particular interest that although the patients in this series presented in a manner similar to that of patients in other published series, the management is significantly different and the overall outcome is significantly better.

Bacterial Infections↗
PubMed1984

The emergency management of caustic ingestions.

In the emergency department, any patient who is suspected of having sustained a caustic ingestion must be handled in a serious manner. All patients should be initially stabilized with regard to airway and circulatory status. Initial questioning concerning the type and quantity of agent ingested will be most helpful. Signs and symptoms of shock, impending perforation, or airway distress take precedence over any further work-up. Patients who have a known history of ingestion require admission to the hospital. Complete physical examination should be carried out, bearing in mind that the lack of oropharyngeal involvement or other symptoms does not rule out the possibility of esophageal burns. One should avoid emesis and should begin early dilutional therapy. Water may be used initially to dislodge adherent solid particles, as well as to dilute the caustic ingestion. It is important not to be excessively aggressive with dilution, as this may cause nausea, vomiting, and possible aspiration. Early otolaryngologic evaluation will be most helpful. The role of early esophagoscopy has been demonstrated to aid greatly in determining the further management. This diagnostic procedure should be carried out within 48 hours after ingestion. Based on the information obtained with esophagoscopy, patients who have had moderate esophageal burns should receive 20 mg methylprednisone intravenously every eight hours if under the age of two and 40 mg intravenously every eight hours if over the age of two. When oral preparations can be used, 2 mg per kg of prednisone should be continued for three to four weeks. Antibiotic coverage should be reserved until the first sign of infection occurs.

Acids↗
PubMed1983

Carbon dioxide laser management of subglottic and tracheal stenosis.

The carbon dioxide laser has been used in a variety of otolaryngologic conditions. Its specific advantages have particularly lent themselves to its use in the airway. The role of laser endoscopic treatment in subglottic and tracheal stenosis will continue to expand and aid in the successful management of these difficult cases.

Carbon Dioxide↗
PubMed1980

Complications of sinusitis in children.

Eight patients (6 to 15 years of age) who had periorbital cellulitis and other complications of sinusitis were studied. Both ethmoid and maxillary sinusitis were present in four patients, frontal sinusitis in two, and ethmoid sinusitis and pansinusitis in one patient each. Subdural empyema occurred in four patients, in one case accompanied by cerebritis and brain abscess and in another by meningitis. Periorbital abscess was present in two children who had ethmoiditis. Alveolar abscess in the upper incisors was present in two children whose infection had spread to the maxillary and ethmoid sinuses. Anaerobic bacteria were isolated from the infected sinuses in all the patients. These were seven isolates of Bacteroides sp, four Fusobacterium sp, three microaerophilic streptococci, three Gram-positive anaerobic cocci, and two Veillonella sp. There was only one aerobic isolate recovered, a group F beta-hemolytic. Streptococcus. Surgical drainage and appropriate antimicrobial therapy resulted in complete eradication of the infection in all patients. The role of anaerobic bacteria in sinus infection and its subsequent complication is discussed. Given the possible serious complications of this disease, the early recognition of sinusitis in children and the institution of appropriate antimicrobial and surgical therapy are of great clinical importance.

Abscess↗
PubMed1976

Operative and non-operative treatment of rachitic lower extremity deformities. A long term study with forty-six year average follow-up.

The long term sequelae of rachitic deformities includes degenerative arthritis. Surgery at an early age will be beneficial in preventing degenerative arthritis in children with severe deformities. Of the many metabolic processes involved with Vitamin D, there must be some that vary quantitatively so that a small alteration may produce rickets in one child, go completely unnoticed in another, and persist in still another as a subclinical disease. Furthermore, it is entirely probable that some children then diagnosed as having classical D-deficiency rickets, in fact, would now be found to have D-resistant states.

Child, Preschool↗
PubMedDate not supplied

Diagnosis of joint effusion on lateral and axial projections of the knee.

Lateral and axial scout radiographs of 100 patients undergoing knee arthrography were evaluated for the presence of joint effusion by multiple observers. Specific observations were characterized. Knee joint effusions were diagnosed with comparable overall accuracy on lateral and axial projections. The combination of both projections increased sensitivity from 75% to 91% and decreased specificity from 87% to 27%.

Exudates and Transudates↗
PubMedDate not supplied

Sickle cell anemia and hearing.

The present investigation examined the effects of sickle cell anemia on threshold hearing. The study included 43 homozygous sickle cell anemia patients, ages 7-18 years, and 23 age-matched controls with documented normal hemoglobin. Both the study and control groups received otologic and audiologic examinations. Bilaterally normal hearing was found in 88% of the sickle cell subjects. Unilateral or bilateral mild high frequency sensorineural hearing loss was demonstrated in 12% (5 of 43). The control subjects revealed no hearing loss. The sickle cell group, therefore, exhibited a higher than usual incidence of hearing loss. Further, three of the five subjects with hearing loss evidenced central nervous system involvement, resulting in a probability of < 0.025 that this relation might occur by chance. Periodic hearing evaluations of children with sickle cell anemia should be performed to identify those with auditory complications and those who possibly may have CNS involvement.

Acoustic Impedance Tests↗
PubMedDate not supplied

Aerobic and anaerobic bacteria in tonsils of children with recurrent tonsillitis.

Tonsils were obtained from 50 children suffering from recurrent tonsillitis. Patients' ages ranged from 2.5 to 17 years (mean 6 years); 29 were males and 21 females. The tonsils were sectioned in half after heat searing of the surface and the core material was cultured for aerobic and anaerobic microorganisms. Mixed aerobic and anaerobic flora was obtained in all patients, yielding an average of 7.8 isolates (4.1 anaerobes and 3.7 aerobes) per specimen. There were 207 anaerobes isolated. The predominant isolates were 101 Bacteroides sp (including 10 B fragilis group, and 47 B melaninogenicus group), 29 Fusobacterium sp, 34 Gram-positive anaerobic cocci (25 Peptococcus sp and 9 Peptostreptococcus sp) and 16 Veillonella sp. There were 185 aerobic isolates. The predominant isolates were 41 alpha-hemolytic streptococci, 24 Staphylococcus aureus, 19 beta-hemolytic streptococci (11 group A, 4 group B, and 2 each group C and F), 14 Haemophilus sp (including 12 H influenzae type B) and 5 H parainfluenzae. Beta-lactamase production was noted in 56 isolates recovered from 37 tonsils. These were all isolates of S aureus (24) and B fragilis (10), 15 of 47 B melaninogenicus (32%), 5 of the 12 B oralis (42%), and 2 of 12 H influenzae type B (17%). Our findings indicate the polymicrobial aerobic and anaerobic nature of deep tonsillar flora in children with recurrent tonsillitis, and demonstrate the presence of many beta-lactamase-producing organisms in 74% of the patients.

Adolescent↗