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Biomedical subjects

A T Davis

Publications and source records attributed to A T Davis.

134 records · Page 8Linked to original sources
PubMedDate not supplied

The psychological impact of pediatric bacterial meningitis on the family.

Twenty-eight families participated in a prospective study of family coping with childhood bacterial meningitis. Most of the parents were seen by physicians and nursing staff as exhibiting anxiety during the first week of treatment, and many mothers later reported their fear for the child's life. Depressive behavior was also commonly noted in mothers by physicians; however, both mothers and fathers were generally seen as cooperating with staff and communicating well with them. Most of the families were rated as coping well with the diagnosis and treatment by physicians, nurses and psychosocial staff. Nineteen families participated in a follow-up assessment 1 to 2 years after diagnosis. Coping was found to be relatively stable over time, and mothers' coping at the follow-up interview was significantly correlated with their coping at diagnosis. Most of them raised concerns about residual damage and fear of life-threatening illness. There were no significant differences between families who had received a psychological intervention and those who had not. Careful monitoring of parental knowledge and perceptions was recommended to prevent later problems.

Anxiety↗
PubMedDate not supplied

Once daily ceftriaxone for central nervous system infections and other serious pediatric infections.

Ceftriaxone has a very long serum half-life and enhanced in vitro activity against common pediatric pathogens. Therefore we evaluated the efficacy and safety of once daily ceftriaxone therapy in 57 children with serious infections including: meningitis (26 patients); ventriculitis (3); pyelonephritis (7); osteomyelitis (6); abscess (4); septic arthritis (3); sepsis (2); and miscellaneous infections (6). The most common isolates were Haemophilus influenzae (23), Escherichia coli (9) and Staphylococcus aureus (8). Ceftriaxone was given intravenously or intramuscularly in a dose of 50 mg/kg for non-central nervous system (CNS) infections. Patients with CNS infections received an initial dose of 100 mg/kg followed by 80 mg/kg 12 hours later and once daily thereafter. In a limited number of patients no major differences in serum ceftriaxone concentrations were found after intravenous or intramuscular injection. Of 57 patients with pathogens isolated 55 were completely cured; in one patient with Klebsiella pneumoniae ventriculitis, intraventricular gentamicin was briefly added to the regimen. Another patient with an anaerobic liver abscess recovered after metronidazole was administered. In three patients a delayed response to ceftriaxone was noted. One patient with previous recurrent infections had a second episode of H. influenzae meningitis 22 days after cessation of therapy. Clinical side effects were noted in 10 of 71 patients (including 14 treated patients who had negative cultures). Seven patients had diarrhea, one each had fever or rash and one had fever, rash and arthralgia. Laboratory side effects in 16 of 71 patients included eosinophilia (7), thrombocytosis (7), elevated liver enzymes (4) and leukopenia and neutropenia (2).(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗
PubMedDate not supplied

Outcomes related to burn-related child abuse: a case series.

Nationally, approximately 10% of child abuse cases involve burning, and up to 20% of pediatric burn admissions involve abuse or neglect. Historically, these cases have been more difficult to prosecute than nonburn cases for multiple reasons. Between 1995 and 1999, there were 285 pediatric (under 18) patients admitted to the Spectrum Health Regional Burn Center. Of these cases, 18 of the alleged perpetrators were legally investigated for suspicion of child abuse, and 7 received punitive sentences. We found that men tended to be prosecuted and convicted more often than women and that cases involving multiple instances of injury tended to be prosecuted more frequently. Similarly, we found that cases involving more severe injuries tended to be prosecuted more successfully. There are many psychological and social factors involved in handling burn abuse cases. However, by successful prosecution of these crimes, victims tend to fare better both socially and psychologically.

Adolescent↗
PubMedDate not supplied

Effect of enteral feeding bag composition and freezing and thawing upon vitamin stability in an enteral feeding solution.

The effect of enteral feeding bag composition and freezing and thawing upon the stability of riboflavin and vitamins A and E in an enteral feeding solution was tested. Feeding bags composed of either polyvinyl chloride or polyethylene were filled with an enteral feeding solution. The samples were frozen for 3 months, thawed in warm water, and allowed to stand in room temperature for 12 hr. Samples for vitamin analysis were obtained prior to freezing, upon thawing, and at 12 hr after thawing. No significant differences in vitamin stability due to bag composition or time were seen. These results support the viability of the concept of mixing large batches of enteral feeding solution, and freezing aliquots in individual feeding bags for later use.

Drug Stability↗
PubMedDate not supplied

Plasma vitamin and mineral status in home parenteral nutrition patients.

Home parenteral nutrition (HPN) provides long-term nutritional support for persons whose absorptive capacity is compromised by a variety of intestinal malabsorption problems. However, the presence of vitamin and mineral deficiency syndromes that normally would not have time to develop in the hospitalized patient receiving total parenteral nutrition has been reported in patients receiving HPN. This study entails a longitudinal survey of plasma concentrations of vitamins A, E, and 1,25-dihydroxyvitamin D, as well as the minerals zinc, copper, and selenium, in patients receiving HPN. Plasma samples from eight patients who had been on HPN for 1-92 months before the study began were obtained once a month over a 12-month period. The blood was drawn immediately before their evening infusion of TPN in order to approximate fasting plasma nutrient concentrations. Patient values were compared to fasting control values and to published norms. Values for vitamin A, 1,25-dihydroxyvitamin D, and zinc all were within the normal range, and there was no evidence of metabolic bone disease. Plasma vitamin E and copper concentrations exceeded the normal range for most of the 12-month period. Of all of the nutrients studied, only plasma selenium concentrations were consistently in the low-normal to below-normal range. Selenium levels in patients on HPN should be monitored regularly, and supplementation may be necessary if clinical conditions warrant.

Adult↗