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Biomedical subjects

R H Sandler

Publications and source records attributed to R H Sandler.

8 recordsLinked to original sources

Development of pediatric and neonatal parenteral nutrition order forms.

The diversity of nutritional needs within the pediatric population makes ordering parenteral nutrition (PN) for infants and children a difficult task for inexperienced clinicians. A well designed PN order form can simplify this task. Standard PN solutions, tables with age-specific nutrient requirements, and guidelines for advancing substrate may improve PN prescriptions and serve as an educational tool. The development of an optimal PN order form for an institution requires consideration of many factors, including the patient population, requirements of the institution, and the needs of the staff and students. One nutrition support team's experience in developing pediatric PN order forms is described.

Age Factors

Fluoroscopic placement of jejunal feeding tubes.

Over a two-and-one-half year period, 50 children underwent placements of jejunal tubes through a nasal route (NJ, n = 47) or through an existing gastrostomy site (GJ, n = 119). There were four attempted placements (98% success rate). The NJ tubes remained in place an average of 13 days, and the GJ tubes remained in place an average of 37 days. Fluoroscopic time for placement of an NJ tube averaged 6 min (29 cases), and for a GJ tube 8 minutes (91 cases). In spite of the limited retention time, fluoroscopic time, and availability of alternative methods, fluoroscopically placed jejunal feeding tubes are still playing an active role in this institution.

Child, Preschool

Esophageal adenocarcinoma 20 years after esophageal atresia repair.

We report a case of esophageal adenocarcinoma 20 years after esophageal atresia repair. From one case report it is premature to recommend cancer surveillance for all esophageal atresia patients. However, the first survivors are now reaching an age when esophageal cancer related to chronic esophagitis may become more prevalent.

Adenocarcinoma

Anaphylactic reactions to zomepirac.

Three cases of apparent anaphylactoid reactions to zomepirac sodium (Zomax) are reported. One patient initially appeared to have a dissecting abdominal aortic aneurysm with vascular collapse. The second patient experienced conjunctival pruritus after each of several doses of zomepirac before emergency department presentation with acute dyspnea and urticaria. The third patient had been admitted previously with a diagnosis of rule out myocardial infarction, which in retrospect was probably a zomepirac reaction. All three recovered uneventfully.

Anaphylaxis