Biomedical subjects

R M Reece

Publications and source records attributed to R M Reece.

14 recordsLinked to original sources

PubMed1990

Unusual manifestations of child abuse.

Cases of child abuse are seen each day in the clinics, emergency departments, private offices, and public and private hospitals. Unusual presentations are intermixed with the straightforward, conventional, and well-understood cases. Fatal pepper aspiration, abdominal injuries ranging from rents in the liver and spleen, transection of the pancreas, and traumatic pseudocysts of that organ are described here. The triad of signs dubbed the "tin ear syndrome" consists of bruising of the ear, retinal hemorrhages, and cerebral edema. Toxic ingestions, mainly of cocaine, and its related paraphernalia are described in addition to peculiar tissue-specific microwave oven burns, an inflicted injury that rational minds find hard to comprehend. Finally, the bizarre syndrome of Münchausen by proxy is reviewed, and some understanding of the dynamics of this disorder has begun. Knowledge about these diagnostic oddities will enable us to intervene and attempt to alter the outcome in these dysfunctional families. The authors would welcome other case reports of unusual manifestations of child abuse, neglect, and child sexual abuse.

Child↗

PubMed1987

Sudden and unexpected death. The pediatrician's response.

When an infant dies suddenly and unexpectedly, the sense of loss and terrible grief may overwhelm not only the parents but also the physician. When that sudden death is due to a known cause, the concrete character of the event can be incorporated into the normal rationalization of mourning. However, when death is due to an unknown mechanism, as in the sudden infant death syndrome, feelings of inadequacy in caring for the child are reinforced. The essential need for support of these families is clear. For physicians, this kind of loss is disquieting and anxiety-provoking. Forty-seven physicians responded to a survey exploring the relationship between the physician and the family after the death of an infant, the feelings of the physician about the death and his or her own sense of loss, and the physician's need for personal support and educational preparation for such an event. While 41 of the physicians indicated they had discussed the death with the family, six had made no contact with the survivors. Thirty-six of the respondents indicated that their relationship with the family continued, and ten physicians stated that their relationship terminated after the death. Physicians characterized their initial responses to the death as frustration, sadness, shock, anger, guilt, regret, hurt, and inadequacy. Most of the physicians believed that they had "missed" something and feared they might be blamed for the death. The competence, sincerity, and sensitivity shown to families during this tragic experience can positively influence the family's mourning and recovery. The pediatrician can provide a rational voice and a medical understanding of tragedy without blame.

Anxiety↗

PubMed1985

Recognition of nonaccidental injury.

Intentional injuries may be grossly underrecognized and underreported. The authors review the literature, provide guidelines for recognizing intentional injuries, and address the problem of identifying intentional injuries. Prevention of these injuries is also addressed and the need for further study is stressed.

Accident Proneness↗

PubMed1983

Child abuse and neglect.

The professional who must deal with child abuse has to resist the urge to punish the offenders and concentrate instead on seeking the best solution for the child. Guidelines for distinguishing child abuse from accidental injury are presented and management of the sexually abused child is detailed.

Child↗

PubMed1979

Child abuse: problems of reporting.

Explore the source record for details and available documents.

Child↗

PubMed1976

Erythema nodosum.

Erythema nodosum (EN) is now more commonly associated with streptococcal disease than with tuberculosis. Sarcoidosis is the third most frequently associated systemic disease. Oral contraceptives now lead the list of drugs associated with EN. The appearance and disappearance of crops of nodules is extremely variable. Salicylates and rest are useful. Steroids are not recommended because they may compromise defenses against an underlying disease process.

Diagnosis, Differential↗

PubMed1976

Anorexia nervosa.

Anorexia nervosa occurs predominantly in white, middle-class, adolescent females with perfectionistic tendencies. Their solution to the intense guilt induced by any sensory pleasure is to deny themselves the pleasure of eating. Amenorrhea is universal. Diagnostic criteria include a 25 percent weight loss. Therapies are long and involved different approaches. All recognize that food is the medicine for the body and that some form of supportive psychotherapy is the medicine for the mind.

Adolescent↗

PubMed1974