New products for pediatrics: 1995.
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Biomedical subjects
Publications and source records attributed to A J Schuman.
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Prescribing fluoride supplements isn't always a simple matter. Fluoride in drinking water, other beverages, and toothpaste can push intake above therapeutic levels and cause fluorosis. New guidelines from the American Dental Association and American Academy of Pediatrics help you decide when and how much supplementation your patients need.
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Two methods of administering home phototherapy were compared. Twenty-two infants received home phototherapy with a fiberoptic cummerbund, and 26 infants received home phototherapy with a conventional four-bul "bililight." The two treatment modalities proved equally effective in lowering bilirubin levels. The duration of treatment was a mean of 3.09 days in the fiberoptic group and 2.77 days in the bililight group, and the daily decline in bilirubin levels was a mean of 1.84 mg/dL/day in the fiberoptic group and 2.18 mg/dL/day in the bililight group. Differences were not statistically significant (Student's t-test, two-tailed). Upon completion of therapy, mothers responded to 15 statements intended to measure attitudes and perceptions regarding home phototherapy. In four of the 15 statements there was a statistically significant preference for fiberoptic therapy, as measured with the chi-square statistic (p less than .05), while in the remaining statements there were no preferences expressed toward either treatment modality. Fiberoptic home phototherapy appears to be as effective as home phototherapy administered with conventional bililights and may be better accepted by parents.
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Pediatrics is a constantly evolving medical specialty. As our knowledge grows through scientific research and careful observation, common pediatric concepts and practices are modified or sometimes even abandoned. Yet, for many reasons, clinicians tend to resist rapid changes and perpetuate antiquated practices, diagnostic strategies, and clinical policies. A number of such practices are presented along with the medical evidence supporting their discontinuation.
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Neural crest tumors can be complicated by secretory diarrhea mediated by vasoactive intestinal peptide (VIP). An eight-month-old male with a several-month history of secretory diarrhea is described. Elevated urine vanillylmandelic acid (VMA), total urine catecholamines, and plasma VIP indicated that a neural crest tumor was responsible for his protracted diarrhea. An extensive search for the tumor including CT scans of his head, neck, thorax, abdomen, and pelvis was unrevealing. A selective vena caval catheterization showed elevated catecholamines in a sample obtained above the renal veins. Subsequent laparotomy disclosed a benign ganglioneuroma arising from the left adrenal; the diarrhea resolved after its removal. Selective venous sampling proved useful in establishing the tumor's location where other techniques had been unsuccessful.