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Biomedical subjects

A Joffe

Publications and source records attributed to A Joffe.

62 records · Page 4Linked to original sources
PubMed1983

Iatrogenic risks and financial costs of hospitalizing febrile infants.

We identified, by diagnostic categories, the iatrogenic and financial costs that arise from hospitalizing febrile infants 60 days of age or younger. Thirty-seven (19.5%) of all admissions resulted in 48 separate complications. Twenty-nine (60.4%) of these complications were preventable, and six complications (12.5%) occurred in infants who probably did not require hospitalization for therapy. Twenty-four (50%) of all complications resulted from intravenous therapy. In addition to the complications, 26 diagnostic misadventures were identified. The average length of hospitalization for all infants was 7.0 days, with a range of two to 28 days. The average cost of hospitalization in 1979-80 dollars was $2,130 per infant, with a range from $6,345 for those infants with bacterial meningitis to $1,480 for those infants with aseptic meningitis. On the average, 25.6% of the bill was for diagnostic studies and 8.3% for physician fees.

Anti-Bacterial Agents↗
PubMed1983

Hospitalization v outpatient treatment of young, febrile infants.

Our medical center has an unwritten policy of admitting all febrile infants younger than 2 months of age. We studied this practice during a three-year period to determine what proportion of the febrile infants who came to the outpatient department were admitted. The characteristics of the infants who were not admitted were compared with those who were. The timing of and the infant's status at a subsequent visit for those not admitted were also identified. One hundred six (35%) of 303 encounters with young, febrile infants did not result in admissions. An infant was more likely to be admitted if he was male, younger than 30 days of age, and febrile (greater than 38.5 degrees C). None of the infants who were followed up as outpatients suffered morbidity that could be directly related to their not having been hospitalized.

Age Factors↗
PubMed1983

Which children with febrile seizures need lumbar puncture? A decision analysis approach.

Whether all children brought to the emergency room with a first seizure and fever require lumbar puncture (LP) remains controversial. We reviewed the emergency room records of 241 children aged 6 months to 6 years who had this clinical picture. Five history and physical examination items discriminated between children with and without meningitis: a physician visit within 48 hours before the seizure; the occurrence of convulsions on arrival at the emergency room; a focal seizure; suspicious findings on physical and/or neurologic examination. Used in combination, these items (risk factors) identified all children with meningitis but would have spared 62% of children without meningitis the need for LP. In a decision analysis framework, they were as sensitive but more specific than LP in detecting children with meningitis. Most important, their negative predictive value was 100%.

Child↗
PubMedDate not supplied

The social and demographic correlates of smoking among young adults in Maryland.

OBJECTIVES: We examine the utility of pooling data from the 1987 through 1994 Maryland Behavioral Risk Factor Surveillance system (BRFSS) surveys in order to increase sample size, and we investigate the social and demographic correlates of smoking in Maryland among 18-24-year-olds. METHODS: The data are from 1,714 subjects who were between 18 and 24 years of age and the principle method was multiple logistic regression. RESULTS: African Americans are less likely to smoke than Caucasians, and people with some college or more are less likely to smoke than those with a high school diploma/GED or less. Men who are in an informal sexual union (cohabitation) are more likely to smoke than men who are not. There is a negative association between being a student and smoking among all young women, which does not exist for men enrolled in postsecondary schools. There is no gender difference in the level of smoking, despite the fact that the predictors of smoking are somewhat different for men and women. CONCLUSIONS: Pooling data from several BRFSS studies is a useful way to increase sample size. Analyses of the correlates of smoking among people from a narrow age range is a useful way of highlighting the unique correlates of smoking across the life course.

Adolescent↗