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R D Mauro

Publications and source records attributed to R D Mauro.

10 recordsLinked to original sources
PubMed1990

Type II errors.

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Colic↗
PubMed1990

The child with simultaneous stridor and wheezing.

We describe 25 patients with simultaneous stridor and wheezing. Twelve patients presented to the emergency department of The Children's Hospital of Denver over a two-year period; we found an additional 13 in a review of the literature. A combination of two disorders produced stridor and wheezing in six patients, with one condition in the extrathoracic airway and one in the intrathoracic airway. The remaining 19 patients had single lesions, nine with obstruction of the extrathoracic airway and 10 with obstruction of the intrathoracic airway. The causes of stridor and wheezing in these 19 patients fell into three general categories: (1) congenital lesion affecting the airway (eight patients); (2) foreign body in the airway or esophagus (nine patients); and (3) acquired lesion affecting the airway (two patients). All eight patients with congenital lesions developed symptoms by four months of age. All nine patients with an airway or esophageal foreign body were between five and 30 months of age. The history may be misleading, and the physical examination often cannot discriminate among the various likely diagnoses. However, the addition of four plain x-ray views (lateral neck, posteroanterior and lateral chest, and forced expiratory chest) located the site of obstruction in 18 of 25 patients. Barium swallow identified the two patients with vascular rings. Four patients underwent endoscopy to determine the site of obstruction. We make recommendations for evaluation of these patients.

Adolescent↗
PubMed1989

Nonorganic failure to thrive: an outpatient approach.

This article reviews our experience, as well as the medical literature, regarding the treatment of failure to thrive (FTT) on an outpatient basis. Nonorganic FTT can be accidental, neglectful, or deliberate. Accidental FTT occurs with errors in formula preparation, diet selection, or feeding technique. These errors can usually be corrected by education and demonstration. Deliberate underfeeding is rare, and these children usually require placement in foster care. Neglectful FTT usually occurs because the mother is overwhelmed or psychologically disturbed. Children with neglectful FTT do not automatically require hospitalization. If the degree of FTT is mild to moderate, the mother-child interaction is positive, the mother is not severely disturbed, and the baby has no inflicted injuries or deprivational behavior, the baby can be safely and more economically managed as an outpatient. Management includes new feeding instructions, a stimulation program, social work intervention, home visits by a public health nurse, and weekly weight checks. Most infants respond to this one-month therapeutic trial with an appropriate weight gain. Even after normal weight is attained, many of these families require long-term follow-up to help them deal with multiple psychosocial issues.

Ambulatory Care↗
PubMed1989

Statistical power.

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Data Interpretation, Statistical↗
PubMed1988

Differentiation of epiglottitis from laryngotracheitis in the child with stridor.

To identify which clinical findings serve to differentiate acute epiglottitis from laryngotracheitis and also to evaluate the role of direct inspection of the epiglottis in the evaluation of children initially thought to have laryngotracheitis, we prospectively evaluated 155 children presenting to the emergency room with acute stridor. Three of the findings on physical examination were associated with epiglottitis: absence of spontaneous cough, drooling, and agitation. The diagnosis assigned prior to inspection of the epiglottis was incorrect in two of six patients with epiglottitis and in three of 149 patients with laryngotracheitis. The diagnosis made after inspection was correct in all 155 patients. Minor complications of inspection were seen in seven patients with laryngotracheitis. No complications were seen in the children with epiglottitis. We conclude that drooling, agitation, and absence of cough are predictors of epiglottitis, but clinical findings alone cannot exclude epiglottitis in every child who appears to have laryngotracheitis. When laryngotracheitis is the suspected diagnosis, inspection of the epiglottis by a pediatrician in a hospital emergency room is an effective aid to the evaluation of the child with acute stridor.

Acute Disease↗