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Biomedical subjects

H L Britton

Publications and source records attributed to H L Britton.

10 recordsLinked to original sources
PubMed1994

Early discharge of the term newborn: a continued dilemma.

OBJECTIVE: To provide the pediatric practitioner with a summary of available data regarding the appropriate time of hospital discharge of the term newborn. METHODOLOGY: Published series on early discharge were critically reviewed. RESULTS: Heterogeneity and limitations of methodology and study design substantially limit conclusions that may be drawn from published studies. CONCLUSION: Early discharge recommendations of the American Academy of Pediatrics remain appropriate, and decisions regarding the timing of discharge of the well term newborn should be individualized and made by the practitioner based upon the medical, social, and economic aspects of each case.

Humans↗
PubMed1991

Use of nonanatomical dolls in the sexual abuse interview.

Controversy exists regarding use of anatomically detailed dolls in child sexual abuse evaluations because of concerns that such dolls may provoke false positive demonstrations of sexually explicit behavior. This study shows that children referred for medical evaluation of sexual abuse will use sexually explicit behavior to demonstrate what has happened to them with nonanatomical dolls as frequently as when they are interviewed with anatomically detailed ones. Over a two-year period, 136 children (aged 24 months to 10 years) were interviewed by the same pediatric interviewer. During the first year sexually anatomically detailed dolls (SAD) were used, and in the subsequent year nonanatomic dolls (NAD) were used. Data was analyzed according to age, sex, and demonstration of sexually explicit behavior. There were 67 children in the NAD group and 69 in the SAD group. Of the NAD group, 72% showed sexually explicit behavior compared to 68% in the SAD group. Comparisons using chi-square analysis revealed no significant differences between NAD and SAD. Results indicated that in the sexual abuse interview setting, use of sexually detailed dolls did not increase children's use of sexually explicit behavior to describe what had happened to them when compared to use of nonanatomical dolls, and that use of either type of doll provides similar information in the interview setting.

Child↗
PubMed1988

High-dose methylprednisolone as initial therapy in patients with acute bronchospasm.

The use of steroids in treating acute respiratory obstruction is still controversial. In this double-blind controlled trial, we decided to examine the beneficial effects of a single large dose of methylprednisolone (MSSP), using objective criteria. In the emergency setting, methylprednisolone (30 mg/kg) has been shown to decrease the need for hospital admission in patients with acute bronchospasm. No difference in this improvement was seen among patients in the steroid-dependent or non-steroid-dependent populations. Based on our findings, we suggest that the early use of single-dose steroid therapy is appropriate treatment for patients with acute bronchospastic attacks.

Acute Disease↗
PubMed1984

Efficacy of early newborn discharge in a middle-class population.

The safety of early newborn discharge was assessed by determining the incidence, time of onset, and nature or problems requiring hospitalization that appeared in the first two weeks of life among 1,735 consecutively born term infants in a private metropolitan hospital. Infants with and without abnormalities during the initial six-hour transitional period were compared. Of 1,583 initially well infants, 11 (0.7%) had problems other than jaundice develop that required hospitalization in the first three days of life. In contrast, 42 (28%) of the 152 infants with abnormal transitional periods required prolonged hospital care; this was statistically significant. The nature of the problems occurring before and after 72 hours was similar, jaundice being the most common and occurring with equal frequency in both periods. Most illness requiring hospitalization in the first three days of life could have been safely detected during an outpatient visit; these findings, in addition to a cost-benefit estimate, suggest that early discharge of initially well infants with careful follow-up may be an effective alternative to a traditional three-day stay.

Arizona↗
PubMed1981

Cost containment through restriction of cephalosporins.

The effect of a program designed to reduce hospital drug costs by limiting the selection of injectable cephalosporins and promoting the rational use of the selected agents was studied. Cefazolin sodium was chosen as the primary injectable cephalosporin, and guidelines for proper dosing were approved. Strict guidelines for the use of cephapirin sodium, cefamandole nafate, and cefoxitin sodium were also adopted; cephalothin sodium was deleted from the formulary. Clinical pharmacists reviewed all cephalosporin orders and consulted with prescribers whose orders did not conform to the guidelines. Total cephalosporin purchases for the first fiscal year of the program were $64,914, a decrease of $55,715 or 46.2% from the previous year's total of $120,629. Cost per patient day for cephalosporins decreased from $0.921 to $0.519 (43.6%) over the same period. The number of milligrams of cephalosporins used per patient day decreased from 398.16 to 178.77 (55.1%), while the number of patient days decreased by only 4.45% during the same interval. The estimated annual cost of monitoring the program was $1500. This program demonstrates that substantial cost savings can be achieved if guidelines for the use of injectable cephalosporins are clearly outlined and strictly enforced.

Cefazolin↗