ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Child abuse by burning may be difficult to recognize, especially since the injuries are often small. Historical and physical findings that can be elicited in the initial examination can be helpful in initiating a more in-depth investigation. An injury inconsistent with the history given or a delay in seeking medical treatment were the two most frequent reports that elicited suspicion. As isolated findings, however, they had a low predictive value. The presence of two or more of 13 factors increased the yield in child abuse identification to more than 60%.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Recently an anatomic model was reported for adults that standardized the platform height for step tests using an individual's stature and a specified hip angle. In order to determine if the model could be used to predict the platform height for children, platform heights were calculated and hip angles were measured in 146 boys and 140 girls ages 6 to 18 years who were divided into four age groups (6 to 8, 9 to 11, 12 to 15, and 16 to 18 years old). There were no statistical differences between measured and calculated hip angles in any of the age groups. In order to determine the validity for predicting maximal oxygen consumption from stepping using a calculated platform height, three step tests were employed using one platform height and stepping frequencies of 22, 26, or 30 ascents/min. Each of the tests was administered to 93 6− to 18-year-olds. Correlation coefficients between the 15-second recovery heart rate after stepping and maximal oxygen consumption measured on a treadmill were .80 at 30 ascents/min, .79 at 26 ascents/min, and .81 at 22 ascents/min. Each of the correlation coefficients was significant at the P < .01 level. It can be concluded that the model is valid for standardizing the platform height for children for use with a single stage step test for estimating maximal oxygen consumption.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

I reviewed the cases of childhood firearms fatalities in the files of the Medical Examiner Department of Metropolitan Dade County, in Miami, Florida. Comparison of cases during the 5-year period from 1966 through 1970 to those during the 5-year period from 1984 through 1988, noting basic epidemiologic parameters, showed that death due to firearms is increasing among children aged 14 years and younger.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A screening for total blood cholesterol levels was conducted by the University of Louisville Department of Family Practice in association with the National Youth Sports Program in Louisville, Kentucky. On May 30, 1987, 224 inner-city children between 10 and 16 years of age were tested; 109 (49%) were girls and 115 (51%) were boys. All participants were black. Of the entire population, the girls had a slightly lower mean level of cholesterol than the boys (160 mg/dL vs 165 mg/dL, respectively). Because of the large number of participants aged 10 to 14 years (211), this subset of children was studied more closely. In this age group, 47 (22%) of the children were at moderate risk for future cardiovascular disease and 48 (23%) were at high risk. The serum cholesterol levels were relatively constant in all children until age 12, after which a slight reduction occurred. This decrease is more evident in boys. Our study also showed a correlation between increased blood cholesterol and above normal weight/height indices (ie, Quetelet scores), with nearly 70% of all children having elevated cholesterol levels also exhibiting above normal Quetelet scores. We observed no correlation between high cholesterol levels and high blood pressure in this study population. Dietary intervention is recommended as the initial treatment for elevated cholesterol levels in children.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In our initial experience with 82 patients, laparoscopic cholecystectomy has shown numerous advantages over open cholecystectomy. Both intraoperative blood loss and postoperative need for pain medication have been minimal. Most patients were discharged within 24 to 36 hours and resumed normal activities within 3 to 5 days. The aesthetic aspect is also an obvious advantage, since the laparoscopic procedure avoids disfiguring abdominal scars. Previous abdominal surgery is not a contraindication to attempting this procedure. Based on our experience, laparoscopic cholecystectomy can be done safely on most patients who are candidates for open cholecystectomy, including the elderly, the obese, and those with acute gangrenous cholecystitis.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We studied the efficacy of infrainguinal bypass for limb salvage in patients with end-stage renal disease. The patency of 42 femoropopliteal and femorodistal bypasses, performed for limb salvage in 37 patients with end-stage renal disease, was assessed with Doppler ultrasonography and dye tests. Patency rates and limb salvage were determined by life-table analysis. Average age was 45 years (range, 28 to 61 years); 23 of the 37 were men. Twenty-three patients had diabetes mellitus, and 16 were smokers. Bypass procedures were done in 32 instances while the patients were maintained with chronic hemodialysis and in five instances with peritoneal dialysis; in five instances the patients had had successful renal transplantation. Indications for revascularization included pain at rest, nonhealing ulcer, or distal gangrene. Femoropopliteal bypass was done in 32 limbs; 10 were more distal procedures. Reversed saphenous vein was the conduit in 30 cases; prosthetic material was used in the remainder. Autogenous material was used in all distal bypasses. Four patients required graft revision during the initial hospitalization, but none thereafter. Two patients died within the operative period, nine within 18 months of operation. Nine major operations were required. Three-month cumulative graft patency was achieved in 41 cases and corresponding limb salvage in 33 cases; 18-month patency was achieved in 34 cases and overall limb salvage in 33 cases. Success of limb salvage most closely correlated with preoperative ankle-brachial ratio and level of bypass required.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

North American mission boards (N = 82) with programs in sub-Saharan Africa were surveyed to identify practices affecting risk of human immunodeficiency virus type 1 (HIV-1) infection among international staff. Thirty-four percent of participating boards thought risk for HIV-1 infection in missionaries in Africa was greater than it was for the general US population, and 53% considered it greater for overseas medical staff serving in the region than for domestic health care workers. Nevertheless, only 24% of boards had formal AIDS education programs for overseas health care workers, and 19% for nonmedical personnel going abroad. Medical care provision and acquisition were considered high-risk activities; 42% of boards with a known policy acknowledged that disposable injection equipment was routinely reused, 68% indicated that immunizations were provided abroad, and 60% admitted that inoculations were administered by indigenous health care workers. The most frequently cited specific suggestion for decreasing the risk of HIV-1 infection overseas was the implementation of a walking blood bank program. We conclude that current practices and logistic constraints make HIV-1 transmission possible. Risk reduction strategies include more comprehensive health education programs, greater adherence to universal precautions, less dependence on the indigenous Third World health care system, and implementation of innovative programs for health care delivery.

ISSN:0038-4348    

出版商:OVID    

年代:1991

数据来源: OVID