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Biomedical subjects

Marina Reznik

Publications and source records attributed to Marina Reznik.

13 recordsLinked to original sources
PubMed2006

Tuberculin skin testing in children.

In 1996, the American Academy of Pediatrics (AAP) recommended targeted tuberculin skin testing (TST) of children while discouraging routine TST of children without risk factors for tuberculosis (TB). Recent studies have provided evidence in support of the targeted TST and recommendations that favor risk assessment over universal screening with TST. While evidence for targeted TB testing exists and benefits of screening programs are clear, administrative logistics could be a greater issue. The challenge for public health and school officials is to develop a screening program that avoids stigmatization of the at-risk group. Until then, pediatric healthcare providers will continue to have a key role in identifying children at risk for latent TB infection by using the AAP-endorsed risk-assessment questionnaire and should screen children with TST only when >1 risk factor is present.

Child↗
PubMed2004

Rubbing ointments and asthma morbidity in adolescents.

OBJECTIVE: To determine the relationship between the use of rubbing ointments and asthma morbidity in adolescents. DESIGN: Cross-sectional study. SETTINGS/LOCATION: Inner-city high school in the Bronx, New York. SUBJECTS: 165 adolescents with asthma. OUTCOME MEASURES: Asthma morbidity, defined as emergency department (ED) use for asthma in the past year and over the lifetime. RESULTS: While 127 (77%) of subjects used albuterol as the first treatment for their last asthma attack, 18 (11%) used rubbing ointments. The rubs and albuterol groups were similar in asthma severity, mean age, gender, and ethnicity. However, subjects in the the rubs group were less likely than subjects in the albuterol group to have made an ED visit over the past 12 months or over their lifetime. Regression analysis revealed that, after controlling for asthma severity, use of rubs independently predicted less lifetime ED use. CONCLUSIONS: After controlling for asthma severity, use of rubs by adolescents with asthma was associated with lower asthma morbidity as measured by ED use.

Adolescent↗
PubMed2004

Inner-city availability of preservative-containing albuterol.

Benzalkonium chloride (BAC) added to nebulized albuterol may induce bronchospasm. The objective of this study was to determine the availability of BAC-containing nebulized albuterol in the Bronx, New York pharmacies. A cross-sectional telephone survey of pharmacies was conducted. Overall, 158 (80%) pharmacies participated in the survey; 133 (84%) carried BAC-containing albuterol; 25 (16%) dispensed BAC-containing albuterol solution when presented with a prescription written for generic albuterol. Only 14 (9%) pharmacists had seen a prescription for nebulized albuterol where a physician specified "without BAC." Despite availability of BAC-free albuterol, pharmacies in the Bronx still carried and dispensed BAC-containing product.

Albuterol↗
PubMed2004

The role of telemedicine in the care of children in under-served communities.

Children living in rural and other medically under-served areas are confronted with a shortage of paediatric specialists. Telemedicine has become increasingly popular as a means of providing health education and medical care to people living in rural areas of the United States and other countries. Some US hospitals have had experience with the use of telemedicine to provide subspecialty services to rural children with special health-care needs and health education for immigrant parents. The Medical Missions for Children, a non-profit organization, aims to provide a 'virtual information bridge' between sponsoring hospitals in the United States and hospitals located in developing nations. The organization serves children in hospitals in 58 countries throughout Latin America, eastern Europe, South Africa, Nigeria and India, and delivers three to four videoconferences per month. Since its inception, the programme has provided teleconsultations and services to approximately 18,000 children annually. In addition, there are on average 50 educational videoconferences per month, during which physicians at the mentoring hospitals exchange ideas with physicians in the developing countries. About 600 educational videoconferences are conducted annually.

Child↗
PubMed2004

Asthma educational videoconferencing for parents: a case-control study.

We used a case-control, pre-post study to determine the effectiveness of educational videoconferencing in the delivery of an asthma education programme. The participants were immigrant parents attending scheduled classes on English as a second language. The cases participated in the educational videoconferences, while the controls attended a class on American civics. Knowledge in both groups was assessed with 10 true/false statements. Ninety subjects participated (47 cases and 43 controls). Controls showed no significant post-test improvement in knowledge scores (6.6 for pre-test, 6.4 for post-test). In contrast, cases demonstrated significant knowledge gain after the videoconference (7.3 vs 8.3). Educational videoconferencing was an effective tool for the delivery of health education in asthma.

Adult↗
PubMed2004

Use of interactive videoconferencing to deliver asthma education to inner-city immigrants.

Videoconferencing to deliver asthma health education to patients or their parents has not been widely used in the USA. We used two 90 min interactive videoconferences to deliver an asthma education programme to a convenience sample of mainly Latino immigrant parents in the Bronx, New York. In these sessions short presentations were given on asthma triggers, medications and the prevention of asthma exacerbations. To test gains in knowledge, we administered a self-completion questionnaire consisting of true/false statements before and after the videoconferences. Sixty subjects participated in the first videoconference and 56 in the second. Asthma knowledge improved significantly after both. Three months later, knowledge retention from the first videoconference was good. The majority of subjects asked questions and commented on their personal experiences of asthma. Interactive videoconferencing allowed asthma education to be delivered to a large immigrant population, elicited concerns from the audience and was effective in improving knowledge.

Asthma↗
PubMed2003

Perceptions and attitudes of adolescents with asthma.

BACKGROUND: Psychosocial factors can limit one's ability to effectively manage asthma. This can result in asthma morbidity that limits quality of life. While self-perceptions of asthmatic children and parents have been studied, less is known about self-perceptions of inner-city adolescents with asthma. OBJECTIVE: To examine perceptions and attitudes to treatment among inner-city adolescents with asthma. DESIGN/METHODS: We conducted a multistaged stratified sample survey at a high school located in the Bronx, NY. First, an asthma-screening survey was administered to 3800 registered students. Then, we identified a subset of 200 children with the most positive screening results for asthma. Next, a 32-item self-completion questionnaire was administered to this cohort. Students were surveyed regarding severity of asthma, perceptions and attitudes, and demographic information. Differences in proportions were tested by Chi-square analyses. Pearson rank-order correlation and multiple logistic regression were used to assess the relationship between perceptions and attitudes to self-treatment. RESULTS: A total of 160 (80%) students participated. Mean age was 15.7 years. Of the respondents, 63% were female. 68% were Hispanic, 26% were African American. 33% had weekly symptoms, and 14% had daily symptoms. Additionally, 41% did not know the name of their asthma medicine. Only 38% reported bringing an "asthma pump" when leaving the house. While 70% reported feeling in control over their asthma symptoms, 63% reported feelings of anxiety and 39% could remember a time when they felt like they were going to die from asthma. Subjects who reported feeling in control over their asthma were more likely to take an asthma pump with them when leaving the house (r = 72, p = 0.004). Only 39% had disclosed their asthma to their friends, and 29% felt embarrassed about having an asthma attack in front of their friends. Subjects who felt embarrassed about their asthma were significantly less likely to take their asthma pumps with them (r = 0.98, p < 0.001) and less likely to use their medications in front of their friends (r = .87, p < 0.001). CONCLUSIONS: Adolescents in this study reported feelings of anxiety, fear, and embarrassment about their asthma. Feelings of control over asthma symptoms were associated with positive attitudes toward self-treatment, while embarrassment was correlated with negative attitudes. These findings have implications for counseling adolescents with asthma about self-management strategies.

Adolescent↗
PubMed2002

Use of complementary therapy by adolescents with asthma.

BACKGROUND: About 40% of adult Americans use complementary or alternative medicine (CAM) for health problems. OBJECTIVE: To determine the prevalence of reported use of CAM in a population of urban adolescents with asthma. DESIGN/METHODS: We used a multistaged, stratified sample approach at an inner-city high school. An asthma screening survey was administered to 3800 registered students, aged 13 to 18 years. We identified a subset of 200 respondents who answered yes to each of the following questions: (1) Does your physician think that you have asthma? (2) Do your parents think that you have asthma? (3) Do you think that you have asthma? A self-completion questionnaire was administered to a sample drawn from this cohort. Differences in proportion were tested by chi( 2) analyses. RESULTS: Of the 160 participants, 63% were female, 68% were Hispanic, 26% were African American, 33% had weekly symptoms, and 14% had daily symptoms. Overall, 80% of participants reported using CAM for asthma. The most commonly reported CAM included rubs (74%), herbal teas (39%), prayer (37%), massage (36%), and Jarabe 7 syrup (24%). Subjects with daily or weekly symptoms were more likely to use CAM for each episode of asthma (72% vs 51%; P =.005). The 61% of subjects who had a family member who used CAM were more likely to use CAM again (84% vs 39%; P<.001). Of the respondents, 59% reported that CAM was effective. Subjects who perceived CAM to be effective were more likely to use it again (96% vs 22%; P<.001). CONCLUSIONS: Most adolescents with asthma in this study used CAM. The prevalence of CAM use in this study population was twice the national average for adults.

Adolescent↗
PubMedDate not supplied

Predictors of early hospital readmission for asthma among inner-city children.

Factors associated with early asthma readmission have not been fully studied. To identify predictors of early readmission, we performed a matched case-control study of children discharged with primary diagnosis of asthma. Cases were readmitted with asthma within 30 days of discharge. Controls were not readmitted. Conditional logistic regression analysis was used. History of asthma hospitalization within the past 12 months was an independent predictor of early readmission (OR 1.89, p = 0.021). Modifiable factors such as medical treatment and management during and upon discharge from the index admission did not predict early asthma readmission.

Adolescent↗