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Biomedical subjects

S Press

Publications and source records attributed to S Press.

At least 19 recordsLinked to original sources
PubMed1998

A fetal alcohol behavior scale.

This research aimed to develop a Fetal Alcohol Behavior Scale (FABS) that describes the behavioral essence of fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE), regardless of age, race, sex, and IQ. Using a reference sample of 472 diagnosed patients with FAS or FAE, ages 2 to 51, five studies are described. The FABS demonstrates high item-to-scale reliability (Cronbach's alpha = 0.91) and good test-retest reliability (r = 0.69) over an average interval of 5 years. It identifies many of the subjects with known or presumed prenatal alcohol exposure in detection studies using both prison and general samples. FABS scores also predict dependent living among adult patients with FAS/FAE. The FABS is uncorrelated with IQ, sex, age, race, and diagnosis (FAS versus FAE). We outline areas of further work to define the specificity and utility of this FABS.

Adolescent↗
PubMed1997

The pacifier thermometer. Comparison of supralingual with rectal temperatures in infants and young children.

OBJECTIVE: To determine the correlation between supralingual temperatures obtained with a new electronic pacifier thermometer (Steridyne) and rectal temperatures obtained with a digital electronic thermometer. DESIGN: Prospective study. SETTING: Pediatric emergency department and pediatric inpatient ward of a tertiary university hospital. PARTICIPANTS: Convenience sample of 100 patients, aged 7 days to 24 months. MAIN OUTCOME MEASURES: A supralingual and rectal temperature were obtained for each patient. For the first 30 patients, the time needed for the pacifier thermometer to signal a final, steady-state reading was recorded. RESULTS: The mean +/- SD difference between rectal temperatures and supralingual temperatures adjusted upward by 0.5 degree F was -0.01 degree F +/- 0.42 degree F (statistically zero) (95% confidence interval, -0.09 degree F to 0.07 degree F). The correlation coefficient between supralingual and rectal temperatures was 0.95. Sensitivity and specificity of the pacifier thermometer for detecting fever (temperature > or = 100.4 degrees F [> or = 38.0 degrees C]) was 72.0% and 98.0%, respectively (positive predictive value, 97.3%; negative predictive value, 77.8%). Increasing supralingual temperatures by 0.5 degree F increased sensitivity to 92.0%, and decreased specificity to 76.0% (positive predictive value, 79.3%; negative predictive value, 90.5%). It took an average time of 3 minutes 23 seconds for the pacifier thermometer to display a steady-state temperature. CONCLUSIONS: The pacifier thermometer evaluated here was found to be an accurate means of temperature measurement when recorded temperatures were adjusted upward by 0.5 degree F. The approximate 3 minutes required for a final temperature determination makes the pacifier thermometer most appropriate for use in low-volume ambulatory care settings and in the home. Further investigation of this device is recommended.

Body Temperature↗
PubMed1994

Electron microscopic localization of nerve growth factor receptor (p75)-immunoreactivity in pars caudalis/medullary dorsal horn of the cat.

Previous studies have demonstrated the presence of nerve growth factor receptor [NGFr(p75)]-immunoreactivity (IR) in the spinal trigeminal nucleus of both 8-10 week-old kittens and mature cats. Most of the NGFr(p75)-IR is lost following retrogasserian rhizotomy, indicating that the majority of the NGFr(p75)-IR within the spinal trigeminal nucleus is of trigeminal primary afferent origin. Here, we examined the ultrastructural localization of NGFr(p75)-IR within lamina II outer of pars caudalis/medullary dorsal horn in the mature cat. Lamina II outer represents a location where dense NGFr(p75)-IR is seen with the light microscope. The NGFr(p75)-IR identified with the electron microscope was located within small thinly myelinated and unmyelinated axons and within axon terminals. The terminals with NGFr(p75)-IR typically formed asymmetric synaptic specializations onto dendritic profiles and at times were postsynaptic to other axon terminals at symmetric synaptic specializations. The terminals with NGFr(p75)-IR were either simple (associated with a single profile) or more complex, such as those that typically formed the central element in synaptic glomeruli. The NGFr(p75)-IR in terminals was especially prominent on microtubules and the plasmalemma and these findings are consistent with proposed roles for NGFr(p75) in axoplasmic/neuronal transport and as a membrane protein, respectively. The profiles with NGFr(p75)-IR seen with the electron microscope indicate a primary afferent origin and show some similarities when compared to other markers of primary afferent fibers such as calcitonin gene-related peptide. In addition, a possible role for NGFr(p75) in the transmission of nociceptive stimuli is also discussed.

Animals↗
PubMed1994

Full-time attending physician coverage in a pediatric emergency department. Effect on risk management.

OBJECTIVE: To determine the effect on risk management of full-time attending physician coverage in a pediatric emergency department. DESIGN: Retrospective, with data collected through a review of malpractice cases from August 1, 1984 through July 31, 1990. SETTING: Large urban teaching hospital's pediatric emergency department. RESULTS: Malpractice cases from August 1, 1984 to July 31, 1987, when there was part-time attending physician coverage, were compared with those of 1987 through 1990, when full-time attending physician coverage was instituted. Medical records from the pediatric emergency department, subsequent hospital records, and abstracts of claims were reviewed. Disbursements and the types of lawsuits were also analyzed. There was a 41.7% decrease in the number of claims filed and a 44.3% reduction in payments with full-time coverage. CONCLUSIONS: Full-time attending physician coverage in a pediatric emergency department was associated with a decrease in the number of malpractice claims and the amounts of disbursements. Further research in this area on a larger study sample is advisable.

Adolescent↗
PubMed1994

Association of hyperpyrexia with serious disease in children.

In a prospective study over 7 years, 105 consecutive pediatric patients with hyperpyrexia (temperature > or = 41.1 degrees C [106 degrees F]) were evaluated to determine the incidence, sensitive indicators, and types of illnesses encountered. The incidence of hyperpyrexia in a large urban pediatric emergency department was 0.36 per 1,000 visits or approximately one in 2,759 visits. In patients with temperature > or = 41.1 degrees C, 65 (61.9%) had a serious illness. Pneumonia (33 lobar, three interstitial, two clinical) was the most common diagnosis (36.2%), followed by probable viral illness in 20 (19.0%) of the patients. Bacteremia (6.7%) and bacterial meningitis (5.7%) were less commonly found. Four (3.8%) patients died. The admission rate was 62.9%. Eighteen patients (17.1%) also had seizures. Sensitive indicators to help distinguish those with serious illness, with the exception of clinical appearance, were not found. Pneumonia is commonly found in children with hyperpyrexia. Temperature > or = 41.1 degrees C was associated with a high rate of serious disease.

Bacteremia↗
PubMed1991

A treatment protocol of the acute asthma patient in a pediatric emergency department.

A treatment protocol for pediatric patients with acute asthma from 8 months to 15 years of age was utilized in an urban pediatric emergency department. In a three month period, 682 children were evaluated with acute asthma with 566 (83.0%) initially discharged and 116 (17.0%) admitted. There were no deaths. Treatment included aerosol inhalation in 682 patients (100%) and both intravenous steroids and aminophylline in 247 (36.2%) patients. Medical care was rendered by housestaff physicians supervised by full-time attending physicians. Of the 566 patients discharged, 131 (21.1%) patients had received intravenous aminophylline and steroids. Of those discharged 14 (2.5%) were admitted during the subsequent 48 hours for status asthmaticus. Of the 247 patients who received intravenous medications, chest radiographs consistent with pneumonia were noted in 15 (6.2%). The routine use of this protocol has been effective in the short term emergency department management of pediatric patients with acute asthma and had been accepted by the housestaff and attending physicians.

Acute Disease↗
PubMed1990

Acute myocarditis in infants. Initial presentation.

The authors reviewed the initial presentation of seven infants with acute myocarditis. All patients presented with respiratory distress including tachypnea (respiratory rate greater than or equal to 40) and intercostal retractions. Other findings included tachycardia (heart rate greater than or equal to 120) (7/7) and grunting (6/7). Lungs were clear to auscultation in six out of the seven patients. Cardiomegaly was seen in five of the initial chest roentgenograms. Each initial electrocardiogram had abnormal findings. Initial diagnoses were sepsis and shock in three patients, pneumonia and asthma in two, and congestive heart failure in two. Six patients required tracheal intubation. All required admission to the Pediatric Intensive Care Unit (ICU). Two patients died. Myocarditis should be suspected in a child presenting with severe respiratory distress, tachycardia, cardiomegaly, and/or an abnormal electrocardiogram. Prompt stabilization and admission to a pediatric intensive care unit for further evaluation and treatment is essential.

Diagnosis, Differential↗
PubMed1985

Association of temperature greater than 41.1 degrees C (106 degrees F) with serious illness.

In a 9-month prospective study conducted in an urban emergency room, 15 children with rectal temperature greater than 41.1 degrees C (106 degrees F) were evaluated. Seven of the 15 patients were admitted to the hospital. Two children who were discharged home required subsequent admission, and six were managed on an ambulatory basis. Eight (53.3%) children had serious disease: two bacterial meningitis, two bacteremia without meningitis, two pneumonia, one pericarditis with effusion, and one Kawasaki disease. In four, the final diagnosis indicated a much more serious illness than was considered initially. The laboratory studies did not correlate reliably with the final diagnosis or need for admission. Children with a rectal temperature greater than 41.1 degrees C are at high risk for a life-threatening illness and should be evaluated for sepsis and meningitis.

Ambulatory Care Facilities↗
PubMed1984

Circumcision using the Mogen clamp.

The purpose of this study was to analyze the results of 313 circumcisions using the Mogen clamp. This procedure was done between 1 day and 2 years of age in all but four patients. The complication rate was low (1.6%). Two patients had local infection, one mild hemorrhage, one concealed penis, and one postcircumcision phimosis. Circumcision using the Mogen clamp is a simple, quick, and safe procedure.

Circumcision, Male↗