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Biomedical subjects

J R Groothuis

Publications and source records attributed to J R Groothuis.

48 records · Page 3Linked to original sources

Effect of carbohydrate ingested on outcome in infants with mild gastroenteritis.

Children with mild acute gastroenteritis have not been observed for specific evidence of lactose intolerance yet are frequently fed a nonlactose formula. To determine whether such intervention is justified, 85 infants with mild acute gastroenteritis were followed prospectively. Infants were blindly and randomly assigned to 20 calorie/oz formula containing one of four carbohydrates: lactose, sucrose, polycose, or combined sucrose-polycose. Daily diaries were kept by parents, and patients were reexamined on days 2, 7, and 14 of the study. Evidence for rotavirus was detected in 23 infants, and five had bacterial pathogens. Symptoms resolved in most patients within 7 days, but five infants were subsequently hospitalized. Stool frequency, weight gain, and need for hospitalization did not differ significantly among the groups. Recovery from mild acute gastroenteritis occurred within 2 weeks irrespective of carbohydrate ingested.

Dietary Carbohydrates↗

Correlation of nasopharyngeal and conjunctival cultures with middle ear fluid cultures in otitis media. A prospective study.

Eighty children with acute otitis media (AOM) were prospectively studied to determine the correlation and clinical usefulness of nasopharyngeal (NP), conjunctival (CONJ), and middle ear fluid (MEF) cultures. NP cultures correlated more accurately with MEF (p less than 0.01) than did CONJ cultures (p less than 0.05) for both Streptococcus pneumoniae and Haemophilus influenzae (H. flu). The positive predictive value of NP cultures for positive MEF was only 47%, but the negative predictive value was 87 percent. NP cultures, therefore, appear to have significant predictive clinical value only when negative in identifying children likely to have sterile MEF. High correlation of NP, CONJ, and MEF in children with H. flu conjunctivitis (p less than 0.01) suggests that early systemic rather than topical antibiotic treatment for H. flu conjunctivitis in small children may avert subsequent occurrence of the "conjunctivitis-otitis" syndrome.

Administration, Oral↗

Twins and twin families. A practical guide to outpatient management.

Little has been written of a practical nature to guide the health professional in providing advice and support to families with twins in the practice setting. This article provides an overview of issues and concerns specific to twins and provides practical guidelines for caring for twins and their families.

Child↗

Telephone encounters in a university pediatric group practice. A 2-year analysis of after-hour calls.

The records of off-hours calls received by the University of Colorado Pediatric Group Practice from 4:30 p.m. throughout 8:00 a.m. weekdays and all day Saturday, Sunday, and holidays were audited. An answering service and pageboy system ensured 24-hour, 7-day-a-week accessibility through a single telephone number. The four practices received 2386 after-hours calls from November 1978 to October 1980. An average of 104 calls per month were received with approximately four calls per day on weekday evenings and six calls per day on Saturday, Sunday, and holidays. Five concerns accounted for 49 percent of all after hours calls: fever, vomiting and/or diarrhea, upper respiratory infection (URI), earache, and rash. While 75 percent of families made fewer than four calls per year, 4 percent made at least 12 calls per year, accounting for 18 percent of all calls. Families calling three or more times a month were defined as "frequent users" and accounted for 22 percent of a given month's calls. Most calls from the same families (55%) occurred within a 24-hour period and dealt chiefly with parental concerns about fever, vomiting and diarrhea, URIs, ear infection, accident, and rashes. The additional responsibility that residents assume in taking calls for the Pediatric Group Practice while on other off-hour assignments was not excessively demanding, and cost of the answering service was easily absorbed by group practice revenues.

Colorado↗

Childhood asthma. Considerations in establishing treatment programs.

This article briefly discusses the natural history of asthma, evaluation strategies, patient education programs for asthmatics and their families, as well as monitoring techniques for outpatient management of the asthmatic child. This information should facilitate an aggressive comprehensive treatment program that will not only minimize symptomatic periods but maximize normalization of the patient's life-style.

Acute Disease↗

Increased child abuse in families with twins.

Close spacing of children may be a significant risk factor for subsequent abuse in some families. Twin births are an extreme example of close spacing. Therefore, the authors hypothesized that twin births may predispose to an increased incidence of child abuse. Thirty-eight families with twins were compared with 97 single birth families and matched for birthdate, maternal age, race, and socioeconomic status. Families with twins experienced a significantly higher incidence of child abuse and neglect than did those with single births (p less than .003). A written questionnaire designed to study mothers' feelings and perceptions of support systems showed a significant difference only in greater difficulty in feeding twins as compared with single infants (p less than .001). Mothers of abused children were more likely not to answer the questionnaire at all (p less than .005). Neither mothers of single births nor those of twins felt that health professionals provided adequate education or support following the birth of their infants.

Child Abuse↗

Increased child abuse in families with twins.

Large families and inadequate spacing of children increase the risk of abuse. Twin births incorporate both of these factors, yet the association of twinning with subsequent abuse has not been explored. Forty-eight families with twins from St Vincent Hospital and Medical Center and Nashville General Hospital were compared with 124 single-birth families, matched for hospital of delivery, birth date, maternal age, race, and socioeconomic status. Three control (2.4%) and nine twin (18.7%) families were reported for maltreatment (P less than .001). Mothers of twins experienced greater previous parity than did control subjects (P less than .001). Twins also had significantly longer nursery stays (P less than .001), lower birth weights (P less than .001), and lower Apgar scores at one (P less than .01) and five (P less than .05) minutes. A regression analysis incorporating all of these variables, however, showed that twin status was most predictive of subsequent abuse.

Adult↗

Lupus-associated chorea in childhood.

Chorea associated with systemic lupus erythematosus (SLE) has been reported in only 28 patients. The clinical and laboratory features of these cases are reviewed here, along with those of a 7-year-old boy who, we believe, represents the youngest child reported to date. In approximately half of these 29 individuals, most of whom were children, chorea preceded other manifestations of SLE. The age range and clinical characteristics of lupus-associated chorea were not appreciably different from those of Sydenham's chorea and most of the patients in whom chorea developed before other manifestations of SLE were initially assumed to have Sydenham's chorea. Systemic lupus erythematosus should especially be considered if chorea begins in the older child or is associated with a persistently elevated erythrocyte sedimentation rate.

Child↗

Pharyngeal gonorrhea in young children.

Among 16,100 visits to a pediatric clinic, 103 children (0.6%) fulfilled criteria for child abuse and 16 of the 103 patients (15.5%) suffered sexual abuse. Throat cultures from 13 children were positive for Neisseria gonorrhoeae in 7 patients (54%). Ages of infected children ranged from 2.5 to 9 years with a mean age of 4.9 years. N. gonorrhoeae was also isolated from cervical (four) and rectal (one) cultures in four of seven patients tested. No child had symptoms related to the oropharynx. All children were treated with a single dose of 100,000 units aqueous procaine penicillin G per kg intramuscularly and 25 mg probenecid per kg orally. Three of the seven children required retreatment for persistently positive pharyngeal cultures. All cases could be traced to sexual abuse by a male contact. Routine culturing of the oropharynx for N. gonorrhoeae in abused children and their siblings may uncover some unsuspected sexual abuse cases.

Adolescent↗

Room air challenge: prediction for successful weaning of oxygen-dependent infants.

OBJECTIVE: The objective of this study was to determine the time required for equilibration of oxygen saturation (SpO2) and the oxygen flow rate that might predict readiness for oxygen weaning to room air in preterm infants with improving bronchopulmonary dysplasia (BPD). STUDY DESIGN: This was a prospective longitudinal cohort study, conducted in the neonatal care unit and the neonatal high risk follow-up clinic. Seventeen preterm children with BPD (mean postconceptual age 39.9 [range 31.5 to 43.5] weeks) were enrolled. With the infants breathing room air, the SpO2 pulse and respiratory rates, and clinical status were monitored for 120 minutes. Factors that predicted a successful room air challenge were determined. Children successfully weaned were followed up for 6 months after discontinuation of oxygen therapy. RESULTS: A total of 20 room air challenges were done in 17 study infants. In most infants the lowest SpO2 value (mean 89.7%) was reached within the first 40 minutes. Infants with an SpO2 > or = 92% at 40 minutes continued to have values > or = 92% at 120 minutes (specificity, 100%; sensitivity, 42%). In all infants receiving oxygen flow rates < or = 20 ml/kg per minute an SpO2 > or = 92% was maintained after 40 and 120 minutes. Infants who were successfully weaned to room air showed maintenance of weight and height percentiles 6 months after discontinuation of oxygen therapy. One child was rehospitalized and oxygen support reinstituted because of viral pneumonia. CONCLUSIONS: An SpO2 value > or = 92% at 40 minutes best predicts readiness for oxygen weaning to room air in infants with improving BPD. Infants requiring oxygen flow rates < or = 20 ml/kg per minute are also likely to be weaned off oxygen support.

Air↗