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Biomedical subjects

M S Sheridan

Publications and source records attributed to M S Sheridan.

16 recordsLinked to original sources
PubMed1994

SIDS and chaos.

Sudden Infant Death Syndrome may exhibit chaotic behavior because it fits common characteristics of chaotic systems including unpredictability, sensitivity to initial conditions, dependence on parameters, and coupling. Chaos theory suggests that preventive efforts should be added to those directed toward a 'cure'.

Humans↗
PubMed1994

Parents' reporting of symptoms in their children: physicians' perceptions.

Pediatricians and family practitioners were asked how accurately parents report young children's symptoms. They believe 5% conceal/fail to report, 8% minimize, 80% report accurately, 10% exaggerate, and 1% falsely report/induce symptoms. They report fewer puzzling cases in their own practices than these estimates would suggest. Health professionals should know the warning signs of Munchausen syndrome by proxy.

Child, Preschool↗
PubMed1990

Munchausen syndrome by proxy and apnea (MBPA). A survey of apnea programs.

The authors sent questionnaires to 127 apnea monitoring programs asking whether they had treated patients whose apnea appeared to have been induced by a parent (Munchausen syndrome by proxy-apnea, or MBPA). Fifty-one programs (40%) reported 54 cases of this kind from among their 20,090 monitored patients (0.27%). The authors obtained further information on 32 of these patients, 83% of whom presented with infantile apnea before the third month of life. Although medical problems were documented, including apnea, the clinical condition of these infants was inconsistent with the multiple life-threatening episodes typically reported by parents. Twenty-one of the infants reportedly received cardiopulmonary resuscitation at home, 15 had ambulance calls to the home, and 24 were rehospitalized. Child Protective Service agencies were consulted for 12 patients, 5 of whom were placed in foster homes. Three index infants and five siblings are known to be dead, and one additional infant is severely brain damaged from abuse.

Apnea↗
PubMed1990

The clinical utility of event recording.

In summary, event recording is a cost-effective means of obtaining objective evidence about a baby's cardiorespiratory patterns at home. It is particularly useful in joint decisionmaking at the time of discharge if parents (or clinicians) remain anxious about the status of a child. Event recording is also indicated in the followup of families where there are multiple or questionable reports of serious events at home. In such instances it may clarify whether symptoms are worthy of concern, and may play a role in problem resolution. Monitors are now available that continuously record events and compliance (for example, the E-link system produced by Corometrics Medical Systems, Inc., Wallingford, Connecticut). Such monitors will reduce parental anxiety, facilitate more prompt diagnosis and treatment of genuine disease states, and make possible the further exploration of relationships between parental anxiety and symptom reporting. Although there are technical trade-offs with such monitors (for example, shorter battery life) and higher personnel costs associated with the transcription of recordings, the total length of monitoring and the need for rehospitalization or evaluation of symptoms may be decreased, thus making such monitors cost effective.

Decision Making↗
PubMed1989

Munchausen syndrome by proxy.

Munchausen syndrome by proxy (MBP) is the deliberate induction or reporting of physical symptoms in a child. It is a form of child abuse that can result in death, iatrogenic disease, or the masking of a genuine illness. MBP is suggested by symptoms that do not follow the usual course of illness, particularly if the symptoms only occur in the presence of the same person. MBP may occur when caretakers (usually mothers) perceive that being the parent of a sick child will solve personal conflicts and be socially rewarded, or if life experiences have demonstrated that the price of love is physical illness. When MBP is suspected, the health care team needs to take aggressive action to confirm or disprove it and to protect the child. A social worker confronted with possible MBP must manage a difficult situation that often involves painful team issues as well as confusion over the nature of reality.

Child↗
PubMed1989

Home monitoring in Hawaii: the first 1,000 patients.

By February 1988, 1,000 Hawaii infants had been prescribed cardiorespiratory monitors for use at home. By 1986, 12.3/1000 live births were being monitored, principally for apnea related to prematurity but also following Apparent Life Threatening Episodes, (ALTE) as subsequent siblings of Sudden Infant Death Syndrome (SIDS) victims, and for an increasing variety of other conditions. Less than 3% of families used the monitor less than 1 week; 30% discontinued sooner than the program recommended. Twenty-seven percent of the monitored infants were judged to have experienced real apnea or bradycardia while on their monitors. Seventeen of the patients are known to be dead, with 2 of these deaths occurring while the symptomatic patient was not monitored. Parents responding to a quality assurance questionnaire were highly enthusiastic about monitoring and felt it was a source of reassurance rather than a stressor. Major problems encountered by monitoring families were related to equipment performance.

Female↗
PubMed1988

Time management in health care social work.

Health care social workers face significant problems in controlling and managing time. Among the causes are increased demands for service, economy measures in health care, and the concurrent responsibility which social workers often have for both ongoing case management and crisis coverage. Individuals and social work departments can increase productivity through streamlining case management, increasing use of available resources, and generating new resources. With planning and preparation, many emergencies can be moved into the expected work flow. The social work profession needs to address time management problems and expectations in a more realistic and systematic way.

Crisis Intervention↗
PubMed1987

Psychosocial impact of emergency apnea.

The pathophysiology of "near miss" or "aborted" sudden infant death syndrome (better termed "emergency apnea") is unclear. Emotionally, however, such episodes are significantly stressful for parents. We administered a questionnaire to 50 families who had experienced emergency apnea at home. Sixty percent ranked the experience as one of the most difficult in their lives; 56% believed that the infant's death was averted only because they intervened. The psychodynamics are similar to those seen in families who have lost an infant to sudden infant death syndrome, and they are consistent with post-traumatic stress disorder. The affected infants may be regarded as "vulnerable children." Many parents believed that their lives were permanently changed. Home apnea monitoring equipment and support from the family physician and monitoring program are important in reducing the stress associated with apneic emergencies.

Adult↗
PubMed1985

Things that go beep in the night: home monitoring for apnea.

Home equipment for cardiorespiratory monitoring now makes it possible for parents to manage more effectively the risks of apnea, or prolonged breathing pauses, in infants. This article examines the features of a social work program that provides parents of apneic infants with education and support. It also demonstrates the important contribution of social work to monitoring.

Home Nursing↗
PubMed1983

Converting enzyme, kininase and angiotensinase of renal and intestinal brush border.

Kinins and angiotensins affect renal and intestinal function and are rapidly converted and/or inactivated in the renal proximal tubule and intestinal tract by converting enzyme, kininases and angiotensinases of the brush border. Converting enzyme accounts for only 40% of intestinal kininases activity. Thus inhibition of converting enzyme by captopril, while completely inhibiting intestinal angiotensin II generation, may only partially inhibit kinin inactivation. In the kidney, however, converting enzyme accounts for the majority of renal kininase activity. Thus the effect of captopril on inhibition of renal angiotensin II formation and kinin inactivation may be similar. Using monospecific antibody to purified converting enzyme and techniques of rocket and fused-rocket immunoelectrophoresis, renal and intestinal converting enzyme can be detected, quantitated and partially characterized. The immunologic localization of renal and intestinal converting enzyme is identical to its enzymatic localization. Immunoelectrophoretic analysis of membrane-bound peptidases is a valuable approach to investigating membrane metabolism of vasoactive peptides.

Animals↗
PubMed1976

Social work services in a high-risk nursery.

Why should a social worker be on the team of a neonatal intensive-care nursery? Helping parents cope with the crises that arise with high-risk births is only one important reason. Ameliorating staff stress is another. Also, by following up the high-risk babies, the social worker has an opportunity to play a preventive role.

Adoption↗
PubMed1975

Children's feelings about the hospital.

The concerned worker needs to know how children perceive the hospital. The institution, the illness, and the procedures evoke specific reactions in children. They fantasize about all of these, and question whether the hospital will help them. Through good communication, consideration, and sound information, it is possible to maximize the positive aspects of a hospitalization experience.

Adolescent↗