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Biomedical subjects

J A Jenista

Publications and source records attributed to J A Jenista.

At least 19 recordsLinked to original sources
PubMed1989

Smoking policy in pediatric hospitals and wards.

The American Academy of Pediatrics has recommended that pediatricians take the lead in banning cigarette smoking in all pediatric health care facilities. This study investigated the use of "nonsmoking" policies and their planned revisions, problems in enforcement, and any history of challenges to restrictive or lenient policies. The surveys were mailed to 329 hospitals affiliated with pediatric training programs as the institutions most likely to attempt to comply with the American Academy of Pediatrics recommendations. Representatives from 199 (60%) of the programs responded. The programs had a range of 12 to 350 pediatric beds in children's hospitals (27%), pediatric wards (69%), or general hospitals (4%). Only nine hospitals were "smoke-free," ie, having no designated indoor area for smoking. Another 35 had "restrictive" policies allowing smoking in only a single site or two preselected sites. Pediatric hospitals or wards were no more likely to have smoke-free policies than general hospitals. Existence of smoke-free or restrictive policies was unrelated to any other factor examined. Smoke-free and restrictive policies were more likely to be rigorously enforced but not more likely to engender formal challenges. Although almost all policies had been recently or are being revised, pediatric hospitals and wards remain remiss in controlling childhood smoke exposure.

Data Collection↗
PubMed1988

Association of clinical presentation, laboratory findings, and virus serotypes with the presence of meningitis in hospitalized infants with enterovirus infection.

One hundred eight hospitalized infants with enteroviral infections were studied to determine the association of clinical presentation, laboratory findings, and virus serotypes with the presence of meningitis. Of 108 infants, 55 (51%) had meningitis. Clinical manifestations on admission did not distinguish between infants with and those without meningitis. Echoviruses 30 and 11 and coxsackie virus B were frequently associated with meningitis (34/38; 90%) whereas echoviruses 18, 24, and 25 were not (5/35; 4%). The virus isolation rate was directly proportional to the number of leukocytes in cerebrospinal fluid: 5 of 58 (9%) when up to 9 cells/mm3 were found, 10 of 21 (48%) when 10 to 99/mm3 cells were found, and 25 of 29 (86%) when greater than equal to 100 cells/mm3 were found. Meningitis is often unsuspected in children hospitalized with enterovirus infection. The frequency of meningitis among hospitalized infants is serotype dependent and is most frequently, but not exclusively, found with pleocytosis of the cerebrospinal fluid.

Cerebrospinal Fluid↗
PubMed1987

Medical problems of foreign-born adopted children.

Over 8000 foreign-born children, almost all from third-world countries, are adopted by citizens of the United States each year. Most primary care practitioners do not have enough experience to evaluate and manage their problems efficiently. We reviewed the medical care of the foreign-born adoptees followed up in a single pediatric group practice. The 128 children arrived from one of eight countries in Asia or Latin America at ages ranging from 1 month to 10 years; 57% were female. The median duration of follow-up was 20 months. The most common problems identified included deficient immunizations (37%), intestinal parasites (29%), emotional or behavioral problems (22%), skin diseases (16%), estimated age (12%), scabies and/or lice (10%), and congenital anomales (10%). Twenty-one other classes of problems were identified, including developmental delay, lactose intolerance, vision and hearing deficits, and chronic hepatitis B carrier status. At arrival or within one month, 49% of the children had acute infectious diseases, including upper respiratory tract infection, otitis media, rubeola, varicella, and mumps. Nineteen percent of the children underwent surgical procedures ranging from circumcision to cleft lip-palate repair; 46% of these children were never screened for hepatitis B. Fourteen percent were hospitalized at least once, 5% within the first month after arrival. We developed a simple protocol to screen foreign-born adopted children, allowing rapid identification of treatable problems at the least cost and inconvenience to the family. Thirty-six percent of the families made at least one preadoption visit, permitting an explanation of the protocol and potential problems before the child's arrival.

Adoption↗
PubMed1985

Viremia in hospitalized children with enterovirus infections.

In a prospective study during the summer and fall of 1982, enterovirus was isolated from 48 hospitalized children; in 29 (60%) enterovirus was isolated from CSF or blood, and in 19 (40%) only a presumptive diagnosis was established. Blood was positive in 21 (44%) and was the only positive specimen in two children. A presumptive diagnosis was provided within 4 days of admission in 38 (80%) and within 48 hours in 19 (40%) of the children from whom enterovirus was isolated. Viremia was most often detected in febrile infants younger than 3 months of age with a clinical picture simulating bacterial sepsis. The presence of viremia was inversely related to the presence of CSF pleocytosis and to virus isolation from CSF. The diagnosis of diseases caused by enterovirus is more accurate when blood culture is added to CSF stool and throat cultures.

Adolescent↗
PubMed1984

The isolation of enteroviruses from blood: a comparison of four processing methods.

Blood from 28 children hospitalized with symptomatic enterovirus infections was processed by four different methods in an effort to define optimum conditions for detecting viremia. Enteroviremia was demonstrated in 11/28 children. Virus was isolated by method 1 (serum) in 7/11 children and by method 2 (mononuclear leukocytes) in 9/11, but in only 3/10 and 3/11 children by methods 3 and 4 (granulocytes and plasma-mixed leukocytes, respectively). In four children, the only blood isolate was from mononuclear leukocytes, and in two, serum was the only positive blood preparation. This suggests that viremia can be often detected in hospitalized children with enterovirus disease and shows that the methods used for processing blood may significantly influence the isolation rate.

Adolescent↗
PubMed1984

The isolation of nonpolio enteroviruses from serum.

Enteroviruses were isolated from 14 of 31 frozen serum specimens obtained from hospitalized patients with enterovirus infection, which had been previously documented by recovery of virus from stool, throat, or cerebrospinal fluid (CSF). Virus was detected in 71% of the positive sera within 3 days of specimen inoculation and serum virus titers ranged from 1.0 X 10(1) to 9.2 X 10(3) plaque-forming units/ml. The data suggest that blood cultures may be useful in the diagnosis of acute enterovirus disease and that use of RD and BGM cells may improve the speed and rate of virus recovery.

Adolescent↗
PubMed1984

Epidemiology of neonatal enterovirus infection.

During a typical enterovirus season in Rochester, New York, none of 666 neonates or 629 mothers were found to be excreting nonpolio enteroviruses within 1 day of delivery. No enteroviruses were isolated from weekly cultures of the 23 infants who died or remained hospitalized during the first month of life. After discharge, culture specimens were obtained in 586 infants at one to four weekly home visits until 1 month of age. The incidence of acquisition of nonpolio enterovirus infection was 12.8%, and the overall prevalence of enterovirus excretion was 5.3%. Risk of virus infection was associated only with lower socioeconomic status (P less than 0.0001) and lack of breast-feeding (P less than 0.0001). Four percent of all infants and 21% of infants in whom cultures for enterovirus were positive were readmitted to the hospital in the first month of life; 79% of infants with positive enterovirus cultures were asymptomatic. We conclude that enterovirus infection during the first month of life is very common in the late summer and early fall. Most infants are asymptomatic, but the risk of hospitalization is high. Breast-feeding may be associated with protection from infection.

Adolescent↗
PubMed1983

Febrile neonates.

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Enterovirus Infections↗