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Biomedical subjects

W D Wilcox

Publications and source records attributed to W D Wilcox.

At least 19 recordsLinked to original sources
PubMed1995

Patient appointment failures in pediatric resident continuity clinics.

OBJECTIVES: To determine appointment failure rates in pediatric resident continuity clinics nationally, and to identify characteristics of clinics with respect to factors that may affect appointment failure rates. DESIGN: A one-page questionnaire administered via facsimile machine to pediatric residencies' continuity clinic directors. RESULTS: Of 200 continuity clinic directors, 160 (80%) returned the survey. The mean no-show percentage was 30.9%, with a range of 3% to 80%. Among the factors studied, only mode of payment emerged as an independent predictor. CONCLUSIONS: Appointment failure is a substantial problem in pediatric resident continuity clinics, which needs attention if resident learning, patient care, and clinic efficiency are to be optimized.

Appointments and Schedules↗
PubMed1994

Tuberculosis in adolescents. A case commentary.

The resurgence of tuberculosis (TB) in the United States has placed a substantial segment of the adolescent population at high risk, particularly those adolescents residing in metropolitan areas. Physicians providing health care to adolescents must be aware of the risk factors for TB and of the epidemiology of this insidious disease. Active alliances must be established among health-care professionals in the community to ensure effective screening, diagnosis, and treatment programs.

Adolescent↗
PubMed1991

Immunogenicity of tetravalent rhesus rotavirus vaccine administered with buffer and oral polio vaccine.

Between January and November 1989, we studied 174 infants aged 6 to 16 weeks in a randomized clinical trial to (1) determine the immunogenicity of a single dose of tetravalent rhesus rotavirus vaccine (RRV-TV) when administered with three different buffer regimens: no antacid buffer and small-volume (2.5-mL) and large-volume (30-mL) antacid buffer; and (2) examine the potential interference of RRV-TV on the immune response to oral polio vaccine. Immunogenicity of RRV-TV, measured as a fourfold rise in antibody titers to rotavirus, was similar in the groups receiving small- and large-dose buffer (45% and 49%, respectively) and significantly less in the group that received RRV-TV alone (23%). Administration of RRV-TV with oral polio vaccine did not significantly interfere with the neutralization response of oral polio vaccine poliovirus serotypes 1, 2, or 3, and overall, 29%, 87%, and 24% of the infants had a fourfold rise in titer to each serotype, respectively.

Antibodies, Viral↗
PubMed1991

U.S. residency directors' views of the importances of seven roles that pediatrics residents should master.

Pediatrics residency programs should define and evaluate for their residents and faculty the competencies that residents should acquire during their three years of training. This 1987 survey of 129 pediatrics residency directors sought data about the demographic characteristics of the programs and asked the program directors to what degree they agreed that seven roles (each comprising several competencies) of the general and ambulatory-care pediatrician were essential. There was strong agreement on the seven roles and no demonstrated association between these responses and the residency programs' university affiliations, types of facilities, ages, lengths of training, or geographic locations. The results of this survey may be useful in developing ways to document and evaluate residents' performances and define subspecialty objectives that are consistent with the seven basic roles.

Attitude of Health Personnel↗
PubMed1990

Thyroid hormone replacement and growth of children with subclinical hypothyroidism and diabetes.

Growth potential among people with Type 1 diabetes and subclinical hypothyroidism may be significantly reduced. Growth was evaluated in 25 children with diabetes who had thyromegaly and elevated thyrotrophin (TSH) levels. All patients appeared clinically euthyroid except for four with short stature. Basal growth rate was significantly lower (p less than 0.005) in Group 1 (TSH greater than 50 mU l-1) and Group 2 (TSH level 10.1-50 mU l-1) than in patients with TSH levels between 5 and 10 mU l-1 (Group 3) or control diabetic children. Serum thyroxine (T4) levels were significantly lower (p less than 0.05) in Group 1 than in Groups 2 or 3. Significant improvement in growth velocity after thyroxine treatment was observed in Group 1 patients compared with those in Groups 2 or 3 (p less than 0.05). More prepubertal test children demonstrated improved growth after beginning thyroxine compared with matched diabetic controls (p less than 0.02). Postpubertal subjects treated with thyroxine did not show significant differences in growth velocity compared with controls. Z-scores for height were not different (p greater than 0.05; ANOVA) between control and test patients for any of the groups. Early detection of subclinical hypothyroidism by thyromegaly, reduced growth velocity, and elevated TSH levels, with institution of thyroxine treatment, can improve growth in prepubertal diabetic children.

Adolescent↗
PubMed1990

Between the lines.

Explore the source record for details and available documents.

Attitude to Health↗
PubMed1989

The cardiovascular abnormalities associated with duplicated segments of chromosome 7.

Congenital heart disease is an integral part of many genetic syndromes such as the major trisomies 13, 18, and 21. Little information, however, is available with reference to the incidence of cardiac anomalies in the trisomy 7 syndromes. Two patients with partial trisomy 7q, one of whom had congenital heart disease, are presented. A review of the literature reveals incomplete description of the cardiovascular abnormalities in the majority of case reports of patients with this syndrome, however, when described it appears that there are no specific defects associated with trisomy 7p and 7q, but only an increased frequency of occurrence. Further clinical and postmortem data regarding details of the congenital heart defects associated with trisomy 7 is required to confirm this preliminary observation.

Chromosomes, Human, Pair 7↗
PubMed1989

Failure to thrive. A continuing problem of definition.

The term "failure to thrive" (FTT) has been used for more than 50 years to describe the infant or young child whose growth falls substantially behind that of his or her peers. Currently, the predominant use of FTT is to describe a child's growth failure resulting from caloric or maternal deprivation or both. Despite widespread use, the term FTT lacks a clarified definition. In this study the authors review 22 current reference texts in general pediatrics, pediatric nutrition, and pediatric gastroenterology and 13 recent journal articles addressing FTT. Only 9 of the 22 texts and 9 of the 13 journal articles describe FTT in quantitative terms, but even these references lack consensus on the anthropometric indices used and their criteria for abnormality. The absence of a standard, scientifically credible definition for FTT, which reflects the dynamic nature of this syndrome, continues to produce an ambiguous body of literature on the subject.

Anthropometry↗
PubMed1986

Systemic Hemophilus influenzae disease in children. A 10-year retrospective study of an urban hospital population.

A 10-year retrospective study of age-frequency, sites of infection, and pre-existing conditions in 297 children with Hemophilus influenzae (HI) disease seen at Grady Memorial Hospital from 1974 through 1984 is described. The majority of the patients were black (73%) and of lower socioeconomic status and were less than 2 years of age. Manifestations of HI disease were similar to those described in reports from other centers, with meningitis being the most common (56.7%). Epiglottitis was much less common in the present study than is generally reported. The death rate of all patients was 1.8 percent. The results of this study indicate that HI disease continues to be a significant risk in children less than 2 years of age.

Age Factors↗
PubMed1985

Direct and indirect blood pressure during exercise.

In 27 subjects, we compared rest and exercise blood pressure (BP) measurements determined directly by catheterization of the radial artery with simultaneous values obtained indirectly by auscultation of the brachial artery. As work increased, the systolic BP increased, whereas the diastolic BP did not change. Considering all comparisons, direct BP was greater than indirect BP by a mean of 29.0 mm Hg for systolic BP and 12.3 mm Hg for diastolic BP. As exercise level increased, the difference between direct and indirect systolic BP decreased whereas the difference between direct and indirect diastolic BP did not change. Both methods have advantages for assessment of BP response to exercise: normality of BP response is best assessed by auscultation, whereas beat-by-beat trends in BP are more accurately defined by the direct method.

Adolescent↗
PubMed1984

M-mode echocardiographic abnormalities in Rocky Mountain spotted fever.

Rocky Mountain spotted fever is a serious acute systemic illness frequently complicated by cardiac involvement. To evaluate the spectrum of myocardial dysfunction, we obtained M-mode echocardiograms on nine consecutive patients with Rocky Mountain spotted fever within 72 hours of admission. Seven of the nine patients had echocardiographic evidence of impaired left ventricular function; two of the seven had no other evidence of cardiac involvement. The extent of impairment of left ventricular function reflected the clinical severity of the illness. Left ventricular myocardial dysfunction is a frequent complication of Rocky Mountain spotted fever. Echocardiography may provide the only clinical evidence of cardiac involvement in these patients.

Child↗
PubMed1983

Range-gated pulsed Doppler ultrasonographic evaluation of carotid arterial blood flow in small preterm infants with patent ductus arteriosus.

Range-gated pulsed Doppler (RGPD) ultrasonography was utilized to study the effect of a patent ductus arteriosus (PDA) on carotid arterial blood flow in small preterm infants. Carotid arterial flow velocity studies were performed on 23 preterm infants, sampling right and left carotid arteries. Studies on seven infants after PDA ligation and on seven who developed no evidence of PDA were used as controls. A strong relationship was demonstrated between diastolic reversal in the carotid arteries and PDA. The results of this study indicate that the RGPD flow velocity curve from the carotid artery is more sensitive than M-mode echocardiography or clinical examination in detecting PDA, and that PDA in small preterm infants is associated with a distinct abnormality in the carotid arterial flow pattern.

Blood Flow Velocity↗