American journal of diseases of children最新文献_第8页

A medical ethics issues survey of residents in five pediatric training programs. 五个儿科培训项目住院医师的医学伦理问题调查。

American journal of diseases of children Pub Date : 1991-02-01 DOI: 10.1001/ARCHPEDI.1991.02160020051015

B. White, G. Hickson, R. Theriot, R. Zaner

{"title":"A medical ethics issues survey of residents in five pediatric training programs.","authors":"B. White, G. Hickson, R. Theriot, R. Zaner","doi":"10.1001/ARCHPEDI.1991.02160020051015","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1991.02160020051015","url":null,"abstract":"Few pediatric training programs offer formal instruction or have ethics consultants to assist residents with ethical dilemmas. Moreover, even if such assistance were available, it is not clear that educators have an adequate understanding of (1) the range and frequency of possible ethical dilemmas residents may encounter, (2) residents' most troublesome concerns, (3) their use of resources to resolve issues, and (4) their own ethics belief systems. A sample of convenience (51 residents) at five midsouth residency programs was queried during 25-minute open-ended interviews to answer ethical questions; there were no refusals to participate. The \"most troublesome\" cases cited by the residents were related to life-and-death issues (withholding and withdrawing life support), child abuse and neglect cases, and disputes regarding patient care that arise between services. Two thirds of those surveyed indicated that they are still somewhat troubled by these difficult ethical problems. Surprisingly, residents stated that they relied on their peers more often than their attending physicians for effective assistance in resolving their most troublesome dilemmas. We support continuing education and research efforts to help residents and educators feel \"more comfortable\" in resolving ethical dilemmas.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"15 1","pages":"161-4"},"PeriodicalIF":0.0,"publicationDate":"1991-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85059768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Elevated plasma norepinephrine levels in infants of substance-abusing mothers. 药物滥用母亲的婴儿血浆去甲肾上腺素水平升高。

American journal of diseases of children Pub Date : 1991-01-01 DOI: 10.1001/ARCHPEDI.1991.02160010046014

Sally L. Davidson Ward, S. Schuetz, L. Wachsman, Xylena D. Bean, Daisy B. Bautista, Sue Buckley, Sabitha Sehgal, David Warburton

{"title":"Elevated plasma norepinephrine levels in infants of substance-abusing mothers.","authors":"Sally L. Davidson Ward, S. Schuetz, L. Wachsman, Xylena D. Bean, Daisy B. Bautista, Sue Buckley, Sabitha Sehgal, David Warburton","doi":"10.1001/ARCHPEDI.1991.02160010046014","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1991.02160010046014","url":null,"abstract":"Infants of substance-abusing mothers (ISAM) have significant growth and neurodevelopmental abnormalities. The origin of these abnormalities is unknown. We postulated that ISAM have increased sympathetic nervous system tone and altered catecholamine levels. Therefore, we measured plasma norepinephrine, epinephrine, and dopamine levels and the number and receptor affinity of beta-adrenoreceptor binding sites on lymphocytes and alpha-adrenoreceptor binding sites on thrombocytes in 22 otherwise healthy ISAM (age, 2.1 +/- 0.5 months; mean +/- SD) and 15 healthy controls (age, 2.5 +/- 0.8 months). Norepinephrine levels in venous blood were 1.8-fold higher in ISAM than in control infants (6.30 +/- 3.85 nmol/L vs 3.55 +/- 2.45 nmol/L). There were no differences in plasma epinephrine or dopamine levels. There were no differences in the number of binding sites or receptor affinity for beta- and alpha-adrenoreceptors. We conclude that ISAM have elevated circulating norepinephrine levels compared with controls. We speculate that this is associated with increased sympathetic nervous system tone in ISAM and that the absence of adrenoreceptor down-regulation may create catecholamine suprasensitivity.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"116 1","pages":"44-8"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79468457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 32

Losing time. 失去的时间。

American journal of diseases of children Pub Date : 1991-01-01 DOI: 10.1001/archpedi.1991.02160060025013

A. Pruitt

引用次数: 1

Reported practices of pediatric residents in the management of attention-deficit hyperactivity disorder. 报告儿科住院医师处理注意缺陷多动障碍的做法。

American journal of diseases of children Pub Date : 1990-12-01 DOI: 10.1001/ARCHPEDI.1990.02150360055019

T. Stancin, N. Christopher, D. Coury

引用次数: 9

Education concerning whiplash shaken infant syndrome: an unmet need. 关于鞭打摇晃婴儿综合症的教育:一个未满足的需求。

American journal of diseases of children Pub Date : 1990-11-01 DOI: 10.1001/ARCHPEDI.1990.02150350010005

C. Kandall

引用次数: 2

Children of mentally retarded parents. 弱智父母的孩子。

American journal of diseases of children Pub Date : 1990-08-01 DOI: 10.1097/00006254-199008000-00014

P. Accardo, B. Whitman

引用次数: 49

Therapy--physical or otherwise--in cerebral palsy. 脑瘫的物理或其他治疗。

American journal of diseases of children Pub Date : 1990-05-01 DOI: 10.1001/ARCHPEDI.1990.02150290013007

S. Stine

引用次数: 0

Pregnancies in human immunodeficiency virus-infected sex partners of hemophilic men. The Hemophilia-AIDS Collaborative Study Group. 血友病男性感染人类免疫缺陷病毒的性伴侣的妊娠。血友病-艾滋病合作研究小组。

American journal of diseases of children Pub Date : 1990-04-01 DOI: 10.1001/ARCHPEDI.1990.02150280107024

J. Jason, B. Evatt

{"title":"Pregnancies in human immunodeficiency virus-infected sex partners of hemophilic men. The Hemophilia-AIDS Collaborative Study Group.","authors":"J. Jason, B. Evatt","doi":"10.1001/ARCHPEDI.1990.02150280107024","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1990.02150280107024","url":null,"abstract":"We investigated 24 completed pregnancies of 20 healthy, human immunodeficiency virus (HIV)-seropositive sex partners of 20 seropositive hemophilic men. One woman had recurrent herpes simplex type 2 infection; no woman was known to use illicit drugs or to have other purported cofactors for vertical HIV transmission. For 8 offspring, the mothers learned of their partners' serostatus and received counseling against pregnancy prior to the fifth month of gestation; for 9 offspring (37.5%), the mothers learned of their own seropositivity and received counseling prior to the fifth month. Acquired immunodeficiency syndrome developed in 7 (35%) of 20 fathers, 4 of whom died; HIV-related symptoms developed in 4; severe liver disease developed in 2; and 7 (35%) were in good health. In four mothers (20%) HIV-related symptoms developed. Five offspring were breast-fed for 2 days to more than 3 years, two while the mother was known to be seropositive; four of these were seronegative and healthy, and one was seropositive at 30 months of age and had persistent cervical lymphadenopathy at 48 months of age. Infants were born at term; median birth weight was 2.86 kg. Solely on the basis of serologic studies and symptoms for those with more than 15 months of follow-up, the minimum perinatal transmission rate for this group of women without putative transmission cofactors (drug usage, promiscuity, malnutrition, HIV symptoms) was at least 25%, a rate comparable to that reported for women in other risk groups.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"33 1","pages":"485-90"},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78935003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Rhesus Rotavirus candidate vaccine. Clinical trial in children vaccinated between 2 and 5 months of age. 恒河轮状病毒候选疫苗。2至5个月大的儿童接种疫苗的临床试验。

American journal of diseases of children Pub Date : 1990-03-01 DOI: 10.1001/ARCHPEDI.1990.02150270035021

T. Vesikari, T. Rautanen, T. Varis, G. Beards, A. Kapikian

{"title":"Rhesus Rotavirus candidate vaccine. Clinical trial in children vaccinated between 2 and 5 months of age.","authors":"T. Vesikari, T. Rautanen, T. Varis, G. Beards, A. Kapikian","doi":"10.1001/ARCHPEDI.1990.02150270035021","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1990.02150270035021","url":null,"abstract":"Live attenuated oral rhesus Rotavirus candidate vaccine (strain MMU 18006 [lot RRV-1]) was evaluated for immunogenicity, safety, and clinical protection in a double-blind, placebo-controlled trial involving 200 infants aged 2 to 5 months when vaccinated. Vaccine-induced fourfold or greater rise of Rotavirus antibodies was seen in 62% of the infants. Febrile reactions of short duration on days 3 and/or 4 after vaccination occurred in 26% of the vaccine recipients. The clinical follow-up covered two Rotavirus seasons, in which serotypes 1 and 4 were prevalent. There were 16 cases of confirmed Rotavirus diarrhea in the placebo-treated group and 10 in the vaccine-treated group; from this a vaccine protection rate of 38% was derived. Clinical severity of Rotavirus diarrhea was assessed by a score; 13 cases in the placebo-treated group and 5 in the vaccine-treated group were regarded as severe or moderately severe, giving a vaccine protection rate of 67%. The rhesus Rotavirus vaccine induces partial protection against heterotypic Rotavirus disease, but the level of protection achieved with the present vaccine dose in this age group appears to be insufficient for a general Rotavirus vaccination.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"2 1","pages":"285-9"},"PeriodicalIF":0.0,"publicationDate":"1990-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90569651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 85

Gastrointestinal milk intolerance of infancy. 婴儿期胃肠乳汁不耐受。

American journal of diseases of children Pub Date : 1990-01-01 DOI: 10.1001/ARCHPEDI.1990.02150250017012

Peter B. Jones

引用次数: 1