K W Kellogg | PubMed Health

PubMed1997

Patient referrals to a multispecialty asthma clinic. Asthma Care Center Clinical Consortium.

A total of 656 patients with asthma have been referred to a multispecialty pediatric asthma clinic for evaluation; 52 (7.9%): mild; 406 (61.9%): moderate; 177 (27%): severe; and 21 (3.2%): incomplete data. No significant differences in demographics or payer source were observed across disease severity levels. Only 25% of the patients with primary care providers were referred by these practitioners. Over 20% of the mild asthmatics were using inhaled bronchodilators regularly. Only 40% and 50% of the moderate and severe asthmatics, respectively, were using inhaled bronchodilators regularly, and only 19% and 36%, respectively, were on maintenance inhaled corticosteroids. Pressures to reduce subspecialty services may place some of these asthma patients at increased risk for complications from this chronic lung disease.

Administration, Inhalation↗

PubMed1994

A multifaceted intervention for infants with failure to thrive. A prospective study.

OBJECTIVE: To determine whether a multifaceted intervention decreased the incidence of failure to thrive (FTT) in a group of preterm infants with low birth weights and improved the 3-year intelligence, health, growth, and behavior status of the children with FTT. DESIGN: Three-year, prospective, randomized, clinical trial. SETTING: Eight large university hospital sites throughout the United States. SAMPLE: Nine hundred fourteen preterm infants with low birth weights who were born at the sites and met study criteria. INTERVENTION: Home visits weekly during the first year of life and biweekly thereafter until the age of 3 years to provide family support and implement two curricula; and attendance at a child development center from 12 months until 3 years of age, 5 days a week, to deliver an early childhood educational intervention. RESULTS: The incidence of FTT did not differ between the treatment and control groups (20% vs 22%). Overall, children with FTT in the treatment group were not different from children with FTT in the follow-up group on any of the outcome variables. However, after controlling for other factors, treatment group membership significantly contributed to the prediction model of 36-month IQ (P = .005) for the children with FTT. In addition, children with FTT in the intervention group with higher compliance demonstrated higher 3-year IQ and better behavior scores than the children with FTT in the low-compliance group. CONCLUSIONS: The intervention did not change the incidence of FTT or the 3-year outcomes in this low-birth-weight, preterm cohort. After controlling for multiple independent variables, marked effects on 3-year IQ were noted. In addition, these beneficial effects were most pronounced in families that were most complaint with the intervention.

Child Behavior↗