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Biomedical subjects

I Benuck

Publications and source records attributed to I Benuck.

16 recordsLinked to original sources
PubMed2001

Identification of adolescent tobacco users in a pediatric practice.

CONTEXT: Though prevention of adolescent tobacco use is a major public health goal, there is little information on the ability of pediatricians to identify adolescents experimenting with tobacco and regular tobacco users. OBJECTIVES: To pilot use of a short questionnaire and analysis of urinary cotinine level to identify adolescent smokers in a pediatric practice, and to determine characteristics of tobacco users. SETTING: Suburban pediatric practice. METHOD: Consecutive high school students completed a short questionnaire and urine cotinine assessment. Three groups were defined: smokers (urine cotinine level >100 ng/mL), experimenters (smoked within the last year; urine continine level </=100 ng/mL), and nonsmokers. Logistic regression was used to examine characteristics of experimenters. RESULTS: One hundred twenty-four adolescents were enrolled throughout 3 months: 83 nonsmokers (67%), 28 experimenters (23%), and 13 smokers (10%). The questionnaire alone identified 92% of regular smokers. Smoking frequency increased by grade level. Smoking initiation occurred with peers. Compared with nonsmokers, smokers and experimenters were more likely to be older and have a majority of friends who smoked. Smokers were more likely to have a family member who smoked. A majority of smokers and experimenters had tried to quit and understood the adverse health effects of tobacco use. CONCLUSIONS: Adolescent smokers and experimenters were identified using a brief questionnaire. This method will allow pediatricians the opportunity to identify at-risk adolescents before they become regular smokers. Further studies at primary care offices are needed to examine identification of adolescents at highest risk and examine methods to initiate smoking cessation before addiction is established.

Adolescent↗
PubMed2001

An opportunity for office-based research.

Robert, a nearly 12-year-old boy, traveled an hour to see a new pediatrician. Robert's mom told the pediatrician that Robert had not been seen by a doctor for several years because "no one seems to be able to help him with his problem." Robert had been wetting the bed "ever since he was toilet-trained" at age 2 years. Robert wets the bed about 5 out of 7 nights. He never has daytime accidents. He did not have a history of urinary tract infection, dysuria, urgency, or increased frequency of urination. He has daily bowel movements and denied soiling or accidents. Robert's mom said he had "toilet-trained himself" at age 2 years. Both Robert's mom and maternal grandfather had nocturnal enuresis "into their teenage years." The pediatrician was surprised to learn that another physician had treated Robert with imipramine at age 5 years. The medication worked intermittently and Robert continued to take it for about a year. At age 6 years, Robert's parents saw an advertisement for a bed-wetting alarm. They purchased the alarm but found that Robert never woke up when the alarm sounded. At age 7 years, Robert saw a urologist who told him he would "outgrow the problem." A year later, the urologist prescribed desmopressin acetate (DDAVP) nasal spray, which Robert took on occasion during the next 2 years. Every time he stopped the DDAVP, he resumed wetting the bed. His parents never punished him for his accidents, but they did try restricting fluids after dinner and also woke Robert in the middle of the night and encouraged him to go to the bathroom. Neither of these strategies was successful. Robert said he was "frustrated" and wondered if "I would still be wetting the bed as a grown-up." The pediatrician explained the nature of enuresis to Robert and his mom, provided them with instructions and an order form for a bed-wetting alarm, and arranged a follow-up visit. The next day, during nursery rounds, he asked several of his colleagues about their approaches to the treatment of enuresis. A few used DDAVP, one found imipramine beneficial, and one preferred behavioral treatment with a bed-wetting alarm. The pediatrician became concerned that he had misread the literature on enuresis. He brought the question up at the next pediatric staff meeting at the local hospital. A lively discussion ensued as the physicians realized that they employed a variety of treatments for enuresis. Robert's pediatrician wondered why his colleagues were not using the alarm because the literature seemed to indicate it to be the preferred treatment for enuresis. He asked the group if they would be interested in talking about the issue further and perhaps trying to understand the reasons for their varied approaches to this problem.

Administration, Intranasal↗
PubMed1995

Year-to-year variability of cholesterol levels in a pediatric practice.

OBJECTIVES: To study the impact of the variability of blood cholesterol levels, which are known to vary spontaneously. The impact of this variability on screening for hypercholesterolemia according to National Cholesterol Education Program (NCEP) guidelines was reviewed in a private pediatric practice. DESIGN: Retrospective chart review. SETTING: Private pediatric practice. PATIENTS: Children (N = 646) aged 3 to 19 years. INTERVENTION: Cholesterol measurements at a mean interval of 19 months between visits. MAIN OUTCOME MEASURES: Year-to-year change in cholesterol levels according to NCEP guidelines, regression to the mean, age, pubertal status, body mass index, hematocrit, interval between measurements, and season of the year were assessed for their contribution to cholesterol level variability. RESULTS: Cholesterol level varied significantly with both age (P < .001) and pubertal status (P < .01) with children aged 9 to 12 years; prepubertal children had the highest levels. Visit-to-visit consistency of NCEP classification was poorer for younger children than for older children (kappa = 0.21 for 3- to 6-year-olds, 0.39 for 6- to 10-year-olds, and 0.44 for those older than 10 years). Of children with initial total cholesterol levels of 5.17 mmol/L (200 mg/dL) or greater, only 40% continued to have high levels at follow-up. A child with an initial cholesterol value of 5.17 mmol/L (200 mg/dL) showed an average decline of 0.34 mmol/L (13 mg/dL) at follow-up by regression analysis. CONCLUSION: Year-to-year variability in total cholesterol level has a significant impact on the stability of NCEP classification.

Adolescent↗
PubMed1992

Usefulness of parental serum total cholesterol levels in identifying children with hypercholesterolemia.

It was hypothesized that healthy children with high cholesterol levels may have parents who exceed acceptable cholesterol levels established by the National Cholesterol Education Program. One hundred sixty families (320 parents, 263 children aged 3 to 10 years) were evaluated for total cholesterol and other risk factors. Before the study, almost half of the parents had not had serum total cholesterol measured. The odds ratio for a child having a total cholesterol greater than or equal to 5.17 mmol/liter (200 mg/dl) was 13.6:1 (confidence interval 5.7 to 32.5) for a child with at least 1 parent having cholesterol greater than or equal to 6.20 mmol/liter (240 mg/dl) versus a child whose parents had low total cholesterol. Testing only children who had at least 1 parent with a total cholesterol greater than or equal to 5.17 mmol/liter (200 mg/dl) had a sensitivity of 98% for detecting children's total cholesterol greater than or equal to 5.17 mmol/liter. It is concluded that parental total cholesterol is useful in identifying children with high total cholesterol levels. Pediatricians may identify a large number of parents with hypercholesterolemia not previously recognized.

Adult↗
PubMed1988

Sudden death in a neonate as a result of herpes simplex infection.

This paper describes a case of a neonate with disseminated herpes simplex born to a 14-year-old asymptomatic mother. The infant's physical examination was normal at birth, and subsequent abnormalities were so subtle that infection was not recognized during life. Postmortem cultures of liver and spleen grew herpes simplex virus, and immunofluorescent direct antibody typing revealed Type 2. A cervical culture of the mother obtained after the infant's death was negative.

Adrenal Glands↗
PubMed1987

Hypertension induced by occult renal tissue.

Hypertension was noted in 2 children thought to have a solitary kidney after multiple radiological studies. Aggressive diagnostic evaluation allowed for detection of occult contralateral renal tissue. Surgical removal of this parenchyma resulted in a return to normal blood pressure.

Child↗
PubMed1986

Malignant external otitis in a diabetic adolescent.

Malignant external otitis (MEO) is an unusual medical problem. The case reported is that of a diabetic adolescent who presented with severe ear pain unresponsive to oral antibiotics and analgesics. The diagnosis of MEO was made, and he was successfully treated with a combination of intravenous anti-Pseudomonas agents. A review of the pediatric cases, guidelines for diagnosis, length of treatment, and prognosis are presented.

Adult↗
PubMed1986

Outcome after prenatal detection of a sporadic, unstable translocation t(5;21).

Amniotic fluid cultures from a 37 year old woman showed a sporadic 46,XX,t(5;21)(5qter----5p13 or p14::5pter----5p13 or p14::21p12----21qter) complement. In the majority of metaphases the 5p fragment was attached to the stalks of chromosome 21; however, in 9% of metaphases, the fragment was loosely attached by a 'thread' and in 6% it was completely detached. Silver staining and in situ hybridisation with a homologous ribosomal gene probe, which localises to stalk regions (nucleolar organisers, NOR) of human acrocentric chromosomes, failed to show a reciprocal exchange. Prognosis was uncertain because the possibility that the 5p fragment might have been lost in some cell lines could not be excluded. Nonetheless, the parents elected to continue the pregnancy. The translocation was confirmed in blood specimens obtained both at birth and at 1 year of age and showed similar instability. However, the proband shows no anomalies and is developing normally at 1 year.

Adult↗
PubMed1975

Brain changes and survival of animals with tumors implanted in the brain.

The effects of tumor cells implanted into the brain of animals on survival rates and gross and microscopic brain changes have been ascertained. Walker carcinosarcoma 256 cell suspensions were injected at several brain sites in rats and leukemia L1210 and P388 and Ehrlich ascites tumor cells, intracerebrally into BDF1 mice. Such neoplasms provided for rapid and rather predictable growth increments. The survival rates were dependent on the number of cells introduced, those receiving the higher counts succumbing first. The brains of the animals revealed fairly discrete space-occupying lesions and neurological symptoms became apparent only hours before death due to intracranial pressure.

Animals↗
PubMed1975

Behavioral parameters in rats and mice bearing tumors, carcinogens and inflammatory agents in the brain.

Walker tumor cells and carcinogens were implanted into the brains of rats and L1210, P388 and Ehrlich ascites tumors, in addition to inflammatory agents and hydrocarbons, injected cortically into mice. Behavioral changes were followed in such animals by several psychological criteria, a discriminated lever-press task in rats and an exploratory task, the poke test, in rats and mice. An activity wheel was also employed for further amplification of mouse behavior. No definite changes could be discerned by these tests between rats bearing tumor or carcinogen and the respective controls as was also the case with levels of activity in the mouse. In marked contrast, mice administered tumors or kaolin cortically demonstrated significant reductions in the mean number of pokes, especially with the higher numbers of cells injected and where neurological symptoms were evident. Behavioral changes, if any, were minimal in mice with cortically implanted carcinogens.

Animals↗
PubMed1974

Influence of stress of lesion growth and on survival of animals bearing parenteral and intracerebral leukemia L1210 and Walker tumors.

Rats with Walker tumor injected intramuscularly in both hind legs and subjected to forced swimming for 15 min daily for 10 days displayed a trend toward decreased lesion size, especially in older intact animals as compared to unexercised intact or bilaterally adrenalectomized controls. Secondary tumor nodules occurred at the lower abdominal or inguinal areas and appeared to be more extensive in the older exercised rats. The survival rates of forced exercised rats bearing Walker tumor cortically did not differ significantly from the respective controls as was also the case with adult BDF1 mice withintraperitoneal or cortical l1210 tumor and subjected daily to electroshock at 0.25mA for 15 min.

Adrenalectomy↗