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Biomedical subjects

Kevin Gordon

Publications and source records attributed to Kevin Gordon.

5 recordsLinked to original sources
PubMed2005

The prognosis of childhood headache: a 20-year follow-up.

BACKGROUND: Headaches affect most children and rank third among illness-related causes of school absenteeism. Although the short-term outcome for most children appears favorable, few studies have reported long-term outcome. OBJECTIVE: To evaluate the long-term prognosis of childhood headaches 20 years after initial diagnosis in a cohort of Atlantic Canadian children who had headaches diagnosed in 1983. METHODS: Ninety-five patients with headaches who consulted 1 of the authors in 1983 were previously studied in 1993. The 77 patients contacted in 1993 were followed up in 2003. A standardized interview protocol was used. RESULTS: Sixty (78%) of 77 patients responded (60 of the 95 of the original cohort). At 20-year follow-up, 16 (27%) were headache free, 20 (33%) had tension-type headaches, 10 (17%) had migraine, and 14 (23%) had migraine and tension-type headaches. Having more than 1 headache type was more prevalent than at diagnosis or initial follow-up (P<.001), and headache type varied across time. Of those with headaches at follow-up, 80% (35/44) described their headaches as moderate or severe, although an improvement in headaches was reported by 29 (66%). Tension-type headaches were more likely than migraine to remit (P<.04). Headache severity at diagnosis was predictive of headache outcome at 20 years. During the month before follow-up, nonprescription medications were used by 31 (70%) of those with ongoing headaches, and prescription medications were used by 6 (14%). However, 20 (45%) believed that nonpharmacological methods were most effective. Medication use increased during the 10 years since last follow-up. No patient used selective serotonin receptor agonists (triptans). CONCLUSIONS: Twenty years after diagnosis of pediatric headache, most patients continue to have headache, although the headache classification often changes across time. Most patients report moderate or severe headache and increasingly choose to care for their headaches pharmacologically.

Canada↗
PubMed2004

Case conference: EMS response to meningococcal meningitis.

This article presents timelines for two emergency medical incidents in which an atypical, unsafe scene was detected and managed by paramedics. Both incidents involved patients who were correctly diagnosed with meningococcal meningitis and meningococcemia (septic shock) by the paramedics on scene. A case review is presented in moderated format to discuss meningococcal disease and to present several points about scene safety in the setting of an infectious disease emergency, management principles for occupational exposures, and the local emergency management approach to a potential public health emergency in a municipality that does not have its own health department or health officer.

Adult↗
PubMed2003

Knowledge and attitudes of pregnant women with regard to collection, testing and banking of cord blood stem cells.

BACKGROUND: Umbilical cord blood is used as a source of hematopoietic stem cells for bone marrow transplantation in the treatment of malignant and nonmalignant disease. We sought to examine pregnant women's knowledge and attitudes regarding cord blood banking, as their support is crucial to the success of cord blood transplant programs. METHODS: A questionnaire examining sociodemographic factors and women's attitudes to cord blood banking was developed on the basis of findings from 2 focus groups and a pilot study. The questionnaire was distributed to 650 women attending antenatal clinics at a regional women's hospital between April and July 2001. RESULTS: A total of 443 women (68%) responded. More than half of the women (307/438 or 70% [95% confidence interval, CI, 66% to 74%]) reported poor or very poor knowledge about cord blood banking. Many of the respondents (299/441 or 68% [95% CI 63% to 72%]) thought that physicians should talk to pregnant women about the collection of cord blood, and they wanted to receive information about this topic from health care professionals (290/441 or 66% [95% CI 61% to 70%]) or prenatal classes (308/441 or 70% [95% CI 65% to 74%]). Most of the women (379/442 or 86% [95% CI 82% to 89%]) would elect to store cord blood in a public bank, many citing altruism as the reason for this choice. A much smaller proportion (63/442 or 14% [95% CI 11% to 18%]) would elect private banking, indicating that this would be a good investment or that they would feel guilty if the blood had not been stored. Additional acceptable uses for cord blood included research (mentioned by 294/436 women or 67% [95% CI 63% to 72%]) and gene therapy (mentioned by 169/437 women or 39% [95% CI 34% to 43%]). INTERPRETATION: Most of the women in this study supported the donation of cord blood to public cord blood banks for potential transplantation and research.

Adolescent↗
PubMed2003

Prehospital management of pediatric SVT.

Accurate prehospital diagnosis and early initiation of emergency medical treatment for pediatric patients found to have supraventricular tachycardia is a reasonable task to accomplish and one that does not have to be anxiety-provoking. The most important point to remember is that the standard approach to resuscitation and stabilization for pediatric patients with narrow complex tachycardias (and those with aberrant or wide complexes identifiable as WPW) applies to all variations of SVT; thus, it is not necessary to precisely diagnose the variant prior to initiation of treatment, except for WPW, in which adenosine administration is contraindicated. Once the dysrhythmia is identified as SVT, the patient must rapidly be categorized as stable or unstable, which will then lead the EMS provider down the correct branch of the treatment algorithm. Every attempt should be made to perform a 12-lead ECG pre- and post-resuscitation, as well at to administer sedation prior to emergent synchronized cardioversion. Dosages of medications need not be memorized, provided that a readily available guide, such as a Broselow tape or regional tertiary care center laminated resuscitation card, is at hand. Finally, while termination of pediatric SVT, whether spontaneous or by EMS intervention, will also likely terminate the EMS provider's own palpitations, it is essential that these patients be seen in an emergency department immediately in order to accurately diagnose their medical condition and provide the patient and family with an appropriate disposition based on the events surrounding the incident.

Cardiovascular Agents↗