Biomedical subjects

Ruth A Etzel

Publications and source records attributed to Ruth A Etzel.

5 recordsLinked to original sources

PubMed2003

Stachybotrys.

Stachybotrys is a toxin-producing fungus that grows indoors when both water and cellulose are available. Epidemiologic evidence has demonstrated an association between acute pulmonary hemorrhage in infants and exposure to Stachybotrys and other fungi in water-damaged home environments. In recent years, advances in understanding of this association have occurred in six major areas: animal models, biologic mechanism of lung injury, dose-response relationship, isolation from diseased patients, detection methods, and intervention. The association demonstrates strength, consistency, coherence, and specificity. While additional data are gathered, a preventive approach to reducing the exposure of infants with pulmonary hemorrhage is suggested.

Adult↗

PubMed2003

How environmental exposures influence the development and exacerbation of asthma.

Environmental exposures may increase a child's risk of developing asthma and also may increase the risk of asthma exacerbations. This article reviews several environmental exposures and suggests whether they contribute to asthma prevalence, asthma exacerbations, or both. Outdoor air exposures and violence are not likely to cause the increase in asthma prevalence. Exposure to outdoor air pollutants primarily leads to increased exacerbations, sometimes manifested as asthma clusters. Clinicians should be alert for space-time clusters of asthma exacerbations in the community, because these clusters may suggest a modifiable point-source exposure. Indoor air exposures are more strongly linked to the increase in asthma prevalence. Exposure to dust mites and tobacco smoke are risk factors for the development of asthma and may also exacerbate existing asthma. Effective measures to prevent exposures to these pollutants are available. With proper management, the amount of environmental exposures can be decreased. Whether decreasing these exposures will result in decreases in asthma prevalence and exacerbations is not yet documented.

Air Pollution↗

PubMed2002

Clinical profile of 30 infants with acute pulmonary hemorrhage in Cleveland.

Between 1993 and 2000, 30 infants were hospitalized with acute pulmonary hemorrhage at Rainbow Babies and Children's Hospital in Cleveland. Most infants presented with severe pulmonary symptoms requiring intensive support, but a few infants had less severe hemorrhage. Three quarters of the patients required ventilator support and blood transfusions. Eleven patients had transitory hemoglobinuria. Five patients died, but infants who survived did well. There are currently no specific treatment modalities, although we have advised moving to a different home and avoiding environmental tobacco smoke. Subsequently, rebleeding from the lower respiratory tract has decreased from 5 of 7 infants to 1 in 21. On the basis of decreased subsequent fatal hemorrhage, high dose glucocorticoids seem to be of some value. Several patients revealed continued low-grade alveolar hemorrhage for months after their initial bleed, even after removal from their original home environments.

Acute Disease↗

PubMedDate not supplied

Mycotoxins.

Explore the source record for details and available documents.

Aflatoxins↗

PubMedDate not supplied

Pediatric environmental health competencies for specialists.

BACKGROUND: Because environmental health problems are complex and require specialty training, the Ambulatory Pediatric Association initiated a 3-year postgraduate fellowship in Pediatric Environmental Health. OBJECTIVE: To develop competencies for the specialty of Pediatric Environmental Health and appropriate measures (performance indicators) for the achievement of these competencies. METHODS: The President of the Ambulatory Pediatric Association appointed a 6-member Fellowship Oversight Committee to guide the development of the Fellowship Program and to draft competencies for fellows in Pediatric Environmental Health. The Committee developed a list of proposed competencies for graduates of Pediatric Environmental Health fellowships. These were skills identified as very important for a specialist to have for minimal competency in the practice of pediatric environmental health. RESULTS: Twenty-seven Pediatric Environmental Health competencies are proposed. The competencies are presented from 3 separate perspectives: academic, individual patient care, and community advocacy. Each competency has a list of suggested performance indicators. CONCLUSION: These competencies are intended to assist in structuring the training experience, achieving consensus with respect to expectations of fellows and faculty, providing opportunities for fellows to assess their own needs or gaps in training, and identifying the expertise of fellowship graduates to potential employers.

Clinical Competence↗