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Biomedical subjects

S Stool

Publications and source records attributed to S Stool.

At least 19 recordsLinked to original sources

The Jehovah's Witness family, transfusions, and pediatric day surgery.

The pediatric otolaryngologist and anesthesiologist, when encountering a family of the Jehovah's Witness (JW) faith, should be aware of the potential problems which may arise when deciding to proceed with surgery. Two case reports are presented which illustrate the difficult situations which can occur when unanticipated complications (i.e. profound bleeding) arise perioperatively. An overview of the history and common tenets of the JW faith, previous legal perspectives, pertinent clinical information from the medical literature, and the protocol of The Children's Hospital, Denver, for dealing with this sensitive issue (drafted with the cooperation of the local JW Hospital Liaison Committee) are presented.

Adenoidectomy↗

Characteristics of objects that cause choking in children.

OBJECTIVE: To characterize the types, shapes, and sizes of objects causing choking or asphyxiation in children and to compare these characteristics to current standards. DESIGN: To evaluate morbidity, retrospective 5-year medical record survey; to evaluate mortality, data reanalysis. SETTINGS: Pediatric hospital and consumer product testing laboratory. PATIENTS: All children (n = 449) who underwent endoscopy for foreign body aspiration or ingestion at Children's Hospital of Pittsburgh (Pa) between 1989 and 1993 and children (n = 449) whose deaths due to choking on man-made objects were recorded by the Consumer Product Safety Commission (CPSC) between 1972 and 1992. MAIN OUTCOME MEASURES: Objects removed from children's aerodigestive tracts were characterized by location, procedure for removal, and type. Objects causing death were characterized by type, shape, and consistency. Three-dimensional objects that had caused asphyxiation were analyzed by computer-simulated models. RESULTS: Of the 165 children treated by endoscopy, 69% were 3 years of age or younger. Foreign bodies most often ingested or aspirated were food (in 36 children) and coins (in 60 children). Of 449 children whose deaths after aspirating foreign bodies were reported to the CPSC, 65% were younger than 3 years. Balloons caused 29% of deaths overall. Conforming objects such as balloons caused a significantly (P < .001) higher proportion of deaths in those aged 3 years or older (60%) vs those younger than 3 years (33%). Of the 101 objects causing deaths that we could analyze, 14 met current standards for use by children of any age. CONCLUSIONS: Balloons pose a high risk of asphyxiation to children of any age. Changes in regulations regarding products intended for children's use might have prevented up to 14 (14%) of 101 deaths in this study.

Adolescent↗

Pediatric voice disorders.

Voice disorders are common among children, estimated to range from 6% to 23% in school-aged children. The various causes of voice disorders are presented in this article in addition to a discussion of normal laryngeal voice and development. Also presented are the causes of abnormal voice and brief discussion of a framework for multidisciplinary assessment and treatment of pediatric voice disorder.

Child↗

Otitis media. Update on a common, frustrating problem.

Otitis media is extremely common in infants and young children and has important ramifications for the children, their families, and society in general. The essential elements of management are early diagnosis, adequate therapy with appropriate antibacterial agents, and conscientious follow-up to promptly detect and treat potential and actual complications. The primary care physician who treats young children is the critical health-care provider in the diagnosis of otitis media, initial treatment, and timely referral when appropriate.

Child↗

Transtracheal high frequency jet ventilation prevents aspiration.

Aspiration is a potentially fatal complication of artificial ventilation. A cuffed tube is generally used now to prevent aspiration; however, it may lead to serious complications and has several disadvantages. High frequency jet ventilation (HFJV) is an innovative technique to prevent aspiration. The trachea of 6 anesthetized, paralyzed dogs was exposed and a catheter for jet ventilation introduced between the 1st and 2nd tracheal ring. Another catheter was used for measuring intratracheal pressure. An endoscope was inserted into the trachea about 2 inches lower down and directed upwards to give a view of the vocal cords from below. A mixture of saliva, saline, and cardiogreen was introduced into the mouth so as to form a pool. When observation confirmed that HFJV prevents aspiration at frequencies of 100/min and ratios of inspiration/expiration (I:E) equalling 1:1, observations were repeated at I:E, 1:2 and 1:3 and at rates of 60/min and 200/min. The depth of the pool was gradually increased to between 2 and 31/4 inches and observations were repeated. Endoscopy alone was used in 4 animals and endoscopic film in 2 to evaluate the efficacy of HFJV. The results showed convincingly that: (1) HFJV can prevent fluid from entering the larynx from above; (2) this effect is unreliable when the frequency is decreased to 60/min or inspiration becomes shorter than 33% of the cycle; (3) intratracheal end-expiratory pressures show values slightly higher than the fluid level above the cords; and (4) the cords are separated and the gas mixture bubbles through the fluid. We conclude that (a) valve mechanisms cannot account for our observations; and (b) at rates above 60/min and with duration of expiration of 66% or less, HFJV will prevent aspiration by causing a continuous gas flow outward through the larynx. This is associated with a low continuous positive airway pressure and excellent blood gases.

Animals↗

Giant cell tumors of the maxilla in children.

Three types of giant cell lesions occur in the facial skeleton; namely, giant cell reparative granuloma, Brown tumor of hyperparathyroidism, and true giant cell tumor -- osteoclastoma preferably called giant cell neoplasm. An appraisal of the clinical course biochemical laboratory data, radiographic appearance, and histological features are all necessary to distinguish between these varieties. Differentiation is a prerequisite to treatment because the management differs in each lesion. Three case reports illustrate these features. The important considerations of facial growth following surgery to the facial skeleton of a child are discussed. Long-term observation is imperative.

Child↗