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Biomedical subjects

M T Stein

Publications and source records attributed to M T Stein.

90 records · Page 5Linked to original sources
PubMed1987

Nutritional rickets in San Diego.

Despite the ability of infants to synthesize vitamin D through exposure to sunlight, nutritional rickets occasionally develops in infants even in areas with perennially sunny climates. In San Diego, a 1-year-old breast-fed infant presented with classic signs of nutritional rickets. Unsupplemented breast milk, limited exposure to sunlight, and darkly pigmented skin were predisposing factors. Because of this occurrence, we conducted a survey of vitamin supplementation practices among pediatricians in San Diego. Twenty-nine percent of 160 respondents do not prescribe vitamin D supplements for breast-fed infants. Those in practice less than ten years were even less likely to prescribe a vitamin supplement compared with their older colleagues. The patient report, coupled with a literature review, suggest the need for vitamin D supplementation for all nursing infants.

California↗
PubMed1985

Fever in infants less than two months of age: spectrum of disease and predictors of outcome.

Four hundred thirty-four febrile infants two months of age or younger were evaluated in the emergency departments of five major teaching hospitals over a one-year period. A culture-proven bacterial infection was present in 3.5% of the infants; bacteremia was detected in 3.3%. Bacterial meningitis was present in 2.4%, and aseptic meningitis was noted in 13.4%. Twenty-one percent had clinically apparent serious disease including pneumonia, otitis media, and gastroenteritis with dehydration. Six variables (age less than 1 month, lethargy, no contact with an ill individual, breast-feeding, total polymorphonuclear greater than or equal to 10,000/mm3 and band count greater than or equal to 500/mm3) were correlated with bacterial infection by step-wise discriminant analysis. However, these findings were neither sensitive nor specific enough to be clinically useful. Management varied, and 62% of the infants were hospitalized. Fifty-four percent, some of whom were managed as outpatients, received antibiotics. Febrile infants two months of age or younger require a comprehensive emergency department assessment, including appropriate laboratory studies (CBC, differential, urinalysis and culture, lumbar puncture, and blood culture), since 3.5% have bacterial infection that may be life-threatening. Hospitalization is warranted if the infant appears ill, laboratory studies indicate serious infection, or follow-up care is uncertain.

Anti-Bacterial Agents↗
PubMed1982

The child with a stiff neck.

The child with a stiff neck can be a challenging diagnostic exercise. Four unusual examples of acute neck stiffness, not associated with meningitis, are presented to illustrate the various pathologic conditions which may produce this symptom. A differential diagnostic schema is suggested on the basis of pathologic and physiologic alterations of cervical and paracervical anatomic structures.

Adolescent↗
PubMed1982

Routine neonatal circumcision: the gap between contemporary policy and practice.

Attitudes, knowledge, and personal factors related to circumcision in the newborn period were analyzed among a group of 92 randomly selected primary care physicians and 103 parents of male infants. Sixty-five percent of the physicians conveyed a positive attitude about routine neonatal circumcision to their patients; pediatricians were more likely to have a neutral attitude, and both family and general practitioners were more likely to encourage routine neonatal circumcision (P less than .01). Routine neonatal circumcision was favored more often by older, male, and circumcised physicians. Knowledge about the normal anatomy of the infants' foreskin was inadequate. Parents rarely perceived physicians as influential in the decision-making process (P less than .001). In contrast, fathers' circumcision status and parental belief in medical indications were positively related to the decision to circumcise (P less than .001 and P less than .01, respectively). The data suggest directions for change in clinical pediatric practice that may bring contemporary policy with regard to routine neonatal circumcision closer to actual practice.

Adult↗
PubMed1981

Delayed roentgenographic signs associated with acute pneumonia in children.

Three cases are reported in order to emphasize occult presentations of pneumonia in children. In each hospitalized child, the initial chest roentgenogram was negative, only to become positive up to five years after presentation. Possible explanations for delayed roentgenographic signs of pneumonia are discussed. Less common signs and symptoms of pneumonia in children of various ages are outlined in order to increase the awareness of primary care physicians to atypical presentation of pneumonia in childhood.

Adolescent↗
PubMed1980

Women who abuse their children: implications for pediatric practice.

Parents who abuse their children may not accept traditional therapy but may be influenced by the child's primary care physician. A comparative study of abusive and nonabusive mothers showed abusers to have lower self-concept and higher self-concept incongruence and inconsistency than nonabusers. They were also found to value authority over others more, and conformity and benevolence less, than nonabusers. Practically applied, the data lead the pediatrician to an educative and supportive role in which he or she may enhance self-esteem and lower unrealistic expectations in the course of treating the child. In addition, there seems to be a need to develop access to support groups, day care, and other avenues for the mother's personal growth. This may be done either within a pediatric practice or through liaison with community resources.

Adult↗
PubMed1979

Clinical hepatotoxicity of isoniazid in children.

A patient is presented with reversible clinical and biochemical hepatocellular injury secondary to isoniazid (INH). This apparently rare drug reaction in children is compared with the more common transient hypertransaminasemia induced by isoniazid. A review of the clinical literature and basic pharmacologic mechanisms of isoniazid-induced hepatotoxicity has led to a rational plan for monitoring and managing children who are treated with INH.

Alanine Transaminase↗
PubMed1977

The providing of well-baby care within parent-infant groups. "Pediatricians are encouraged to explore the parent-infant group model in their practices".

A model has been described for the practice of pediatrics using parent-infant groups. In a one year experience, three parent-infant groups met at monthly intervals. A one-hour parent discussion was followed by examination of the infants within the group setting. Among the benefits observed were much more attention of well-baby care and infant development, and the surfacing and alleviation of parental concerns and anxieties.

California↗