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Biomedical subjects

P D Fosarelli

Publications and source records attributed to P D Fosarelli.

12 recordsLinked to original sources
PubMed1990

Prevalence of human immunodeficiency virus seropositivity in pediatric emergency room patients undergoing phlebotomy.

Information on the prevalence of human immunodeficiency virus (HIV) infection among children and adolescents requiring medical care is sparse. A small but significant risk of seroconversion occurs in health care workers who handle blood and body fluids of patients infected with HIV. The prevalence of HIV seropositivity in children who had phlebotomy as part of emergency care was measured. Of 749 blood samples, 21 (2.8%) tested positive for HIV antibody by enzyme-linked immunosorbent assay and Western Blot analysis: 14 samples from 6 patients with hemophilia, 6 from 3 patients with acquired immunodeficiency syndrome/acquired immunodeficiency syndrome-related complex, and 1 from a patient with asthma. Of these 21 blood samples, 10 were from 4 children previously known to be HIV positive, 4 were from patients with a known parental risk factor, and 16 were from patients with known history of blood transfusion. One sample was from a children with unknown HIV status and no documented risk factors. Procedures included 9 venipunctures, 17 intravenous line placements, 1 lumbar puncture, and 1 pelvic examination. Most patients with HIV seropositivity had been known to be HIV seropositive or at significant risk for HIV seropositivity. Although the potential risk to health care workers from children without known risk factors for HIV seropositivity was small in this population, the currently recommended infection-control precautions should always be observed.

Adolescent↗
PubMed1987

Telephone call-in services for children in self-care.

An estimated 8 to 10 million American children younger than 18 years of age are in self-care before or after school. Telephone call-in services to provide adult contact for these children when telephone contact with their parents is impossible or not feasible have been developed in more than 100 cities throughout the country. This study describes 2082 calls received by Tucson's KIDLINE and 2208 calls received by Baltimore's KIDSLINE. The mean age of the callers was 9.7 years, with twice as many girls as boys calling. Loneliness or boredom accounted for 68% of the calls, with fewer calls for help with homework (8%), interpersonal problems (6%), medical problems (3%), and fears (2%). Medical calls were mostly for minor infectious illness; there were no calls for life-threatening emergencies. We discuss the possible implications for pediatric practice.

Adolescent↗
PubMed1987

Outpatient radiographic exposure in the first five years of life.

Young children receive a variety of diagnostic radiographs over time. In some cases the exposure to radiation may be unwarranted because the films may yield confusing results, or may also need to be repeated because of poor technical quality. Even when the results are clearly negative, the subsequent treatment may proceed as if the film had been positive because of the child's clinical condition. The cumulative effect of such low-dose radiation on infants and children over time is unknown. The number and types of outpatient radiographs received by a cohort of poor children from a hospital-based continuity clinic during their first 5 years of life were reviewed. Also noted were the reason for obtaining the film, whether it was positive for that reason or another, whether the child had a chronic condition that prompted the use of radiograph, and the child's sex, race, and age when the film was obtained. Of the 218 children, 132 (60.6%) received 349 sets of films in their first 5 years. There was no difference in the number of films by race or sex. Chest and posttrauma bone or joint films accounted for 315 sets of films or 90.3% of the total. Overall, 25.8% of the 267 chest films were positive; this varied by age. Only 15% of the chest films were positive in the first year compared with 29 to 49% in the second through fifth years (p less than 0.001). Cough was the respiratory symptom most reliably associated with a positive chest film, both for the cohort (p less than 0.0001) and for children in the first year of life (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1987

Childhood fever: correlation of diagnosis with temperature response to acetaminophen.

Many people believe that temperature response to antipyretics in febrile children varies according to diagnosis. To evaluate the validity of this premise, we prospectively studied the temperature response to acetaminophen of febrile children who came to an urban pediatric emergency and walk-in facility. The study group consisted of 1,559 patients between the ages of 8 weeks and 6 years whose temperatures when seen were greater than 38.4 degrees C and who had not received antipyretic treatment within the previous four hours. Acetaminophen (15 mg/kg) was administered to each child and repeat temperatures were taken one and two hours later. Patient management was unaffected by the study, and physicians were unaware of the repeat temperature measurements. Telephone follow-up was conducted with the parents of each child within five days of the initial visit. Children with cultures positive for bacterial disease or chest x-ray films positive for pneumonia had slightly greater one- and two-hour temperature decreases compared with children with other diagnoses. Although statistically significant, we do not consider these differences in response to be clinically useful. We conclude that fever response to acetaminophen is not a clinically useful indicator by which to differentiate the causes of febrile illnesses in young children.

Acetaminophen↗
PubMed1987

Health services use by children enrolled in a hospital-based primary care clinic: a longitudinal perspective.

The use of a hospital-based primary care clinic for health maintenance and illness care and use of the emergency room were monitored for 3 years for 293 children who had been enrolled in the clinic as infants. Infrequent users of one facet of care were infrequent users of other facets of care, and they remained so for all 3 years. The same trends were noted for frequent users. Children who used the clinic for health maintenance infrequently were more likely to have registered in the clinic after 2 months of age and to demonstrate consistently infrequent use throughout the 3 years. Children who used the clinic for illness care infrequently were more likely to have at least two siblings and to demonstrate consistently infrequent use. Children who used the emergency room infrequently were likely to have been consistently infrequent users for emergencies and illness throughout the 3 years. Conversely, those who used the clinic frequently for health maintenance were more likely to have registered before 1 month of age, to have multiple chronic conditions, and to demonstrate consistently frequent use for maintenance throughout the 3 years. Frequent users for illness care were more likely to have none or one sibling, multiple chronic conditions, and to demonstrate consistently frequent use for illnesses. Finally, children who used the emergency room frequently were likely to have multiple chronic conditions and to demonstrate sustained frequent use throughout the 3 years. These results suggest that patterns of use are established as early as the first year of life.

Ambulatory Care Facilities↗
PubMed1984

Latchkey children.

This report reviews the subject of latchkey children. It provides statistics on the number and ages of children involved and the hours per day that they remain without parental supervision. The results and methodological problems of the few studies on latchkey children are discussed, and suggestions for future research are offered. Possible solutions for these children and their parents are suggested.

Adaptation, Psychological↗
PubMed1984

Television and children: a review.

Television plays an important role in the lives of children, and for some a larger role than that of parents and schools. There are many educational, social, and recreational benefits gained from viewing television for persons of all ages. Detrimental effects, however, are also possible, especially if the viewer lacks the knowledge or emotional maturity to place a program in its proper perspective. Debate has centered on whose responsibility it is to provide children with this understanding and perspective, so that television's benefits outweigh its detriments. This article reviews current research on the amount of television viewing by children, their reasons for doing so, and their understanding of what they see on television. The relationship is discussed between this understanding and the positive and negative effects of certain types of programs and advertisements. Suggestions for educational interventions by parents and teachers are provided.

Adolescent↗
PubMed1983

The telephone in pediatric medicine. A review.

From a review of numerous studies and reports of management of pediatric illness by telephone, it is concluded that innovative methods of teaching effective diagnosis and management by telephone still need to be explored. More research should be done on patient outcomes to assess the adequacy of the initial decision-making process, rather than relying solely on the number of questions asked. This will necessitate studies using actual patient telephone vignettes rather than simulated ones. Finally, research needs to be done on the efficacy of the "telephone hour" used by many physicians to manage their day more efficiently. Such studies could compare patient outcome and parent and physician satisfaction, in practices where the "telephone hour" is standard, to those practices where patient calls are managed as they occur.

Diagnosis↗
PubMedDate not supplied

Infectious illnesses in the first two years of life.

The number and types of infectious illnesses experienced in 1 year by 279 inner city infants younger than 12 months were examined and correlated with some personal and social attributes and the children. Only 24 (8.6%) infants incurred no infectious illnesses in 12 months. The children experienced an average of one episode of otitis media (OM), one upper respiratory illness and three total illnesses during the year. Only 7.5 and 2.2% of the children experienced more than two episodes of upper respiratory illnesses and gastroenteritis, respectively, but 19% of the infants incurred more than two episodes of OM. The months with the highest number of illnesses for both the entire cohort and the infants who were enrolled at 1 month or less of life were March-April and October-November. The months in which the fewest illnesses occurred were August-September for both groups. The only variable associated with an increased number of total illnesses was a personal history of eczema or allergy (P less than 0.01). No variables were found to be associated with the occurrences of pneumonia, gastroenteritis or upper respiratory illnesses. Multiple episodes of OM during the study period were associated with male sex (P less than 0.01), bottle feeding (p less than 0.05) and a history of OM before the onset of the study (P less than 0.01).

Age Factors↗