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Biomedical subjects

D E Trachtenbarg

Publications and source records attributed to D E Trachtenbarg.

12 recordsLinked to original sources
PubMed1998

Office care of the premature infant: Part II. Common medical and surgical problems.

Medical problems associated with prematurity are frequently complex, and a multidisciplinary approach is often required. Some common problems include the following: (1) anemia, which can be reduced by iron supplementation, (2) cerebral palsy or mental retardation as a result of intraventricular hemorrhage or periventricular leukomalacia, (3) respiratory problems, including bronchopulmonary dysplasia and apnea, (4) visual problems, such as those associated with retinopathy of prematurity, (5) gastroesophageal reflux and (6) surgical problems, including inguinal or umbilical hernia and cryptorchidism. Monitoring of growth and development includes recording the infant's head circumference, weight and length on a growth chart for premature infants. Nutritional status should be assessed at each visit, watching for hyperosmolar problems in infants receiving high-calorie formulas. Consultation with other specialists may be required if abnormalities are identified during follow-up care in the office.

Chronic Disease↗
PubMed1998

Care of the premature infant: Part I. Monitoring growth and development.

When monitoring growth and development in the premature infant, physicians should make adjustments for the estimated due date. With minor exceptions, administration of immunizations is based on the chronologic age. Administration of hepatitis B vaccine should be delayed until the infant weighs 2,000 g (4 lb, 5 oz). Administration of influenza vaccine should be considered in infants with chronic medical problems, and the pneumococcal vaccine may be beneficial at age two in children with chronic problems, especially pulmonary disease. Premature infants should also be monitored to assure appropriate nutrition. Breast-fed infants should probably receive vitamin supplements during the first year. Supplemental iron should be initiated at two weeks to two months after birth and continued for 12 to 15 months. Office care includes screening for problems that occur more frequently in premature infants, especially vision and hearing problems. Because many of these infants require care from multiple medical disciplines, coordination of care is another important role for the family physician. The goals of this care are to promote normal growth and development and minimize morbidity and mortality.

Deficiency Diseases↗
PubMed1998

Ten errors to avoid in managing type 2 diabetes. Getting back to the basics.

It is important to remember the basics when treating patients with diabetes. Follow current diagnostic criteria, and clearly communicate findings to patients. Set target glucose levels, and encourage patients to take an active role in controlling their disease. Set time limits for therapy effectiveness, and use combination therapy with caution. Recommend use of home glucose monitors and regular monitoring of glucose levels throughout the day. For more flexibility, adapt insulin dosages to patient needs and use basal insulin, rather than sliding-scale insulin. Finally, remember that early detection and intervention can delay or even prevent complications.

Blood Glucose↗
PubMed1996

Getting the lead out: when is treatment necessary?

Lead poisoning is a continuing health concern, especially in children. Screening mandates by states, in addition to evidence that lead is toxic at lower levels than previously thought, make it increasingly important for physicians to have an understanding of this problem. Careful history taking focused on potential lead exposure from environmental, occupational, and recreational sources aids in detection and treatment. Avoidance of further lead exposure is the chief intervention in all patients at risk. Chelation therapy should be considered when blood lead levels reach 25 mg/dL in children and 51 mg/dL in adults.

Adolescent↗
PubMed1995

Office care of the small, premature infant.

About 1% of infants are born before 32 weeks of pregnancy, and 0.9% have a birthweight of 1500 gm or less. More of these premature infants are surviving. Contributing factors include prenatal corticosteroid therapy and early surfactant therapy to reduce the incidence of respiratory distress syndrome. Because of this, more family physicians are providing office care for premature infants after discharge from neonatal intensive care centers. These infants require special care in the office as well as the neonatal intensive care unit. The goal of the family physician's care should be to minimize mortality and morbidity. This article summarizes recommendations for office care of the surviving premature infant.

Developmental Disabilities↗
PubMed1994

Tension headaches. Relieving pain without creating dependence.

Almost half of headaches that are treated in a primary care practice are of the tension type. The diagnosis is made primarily on the basis of a history of bilateral mild or moderate headache with a pressing or tightening quality, often located in the hatband region and sometimes extending down the back of the neck. Laboratory tests and imaging studies are indicated only for selected patients to rule out other causes. A stepwise approach to treatment, starting with reduction of precipitating factors and use of over-the-counter analgesic medications, is often helpful. Prophylaxis should be considered if tension headaches occur more than twice a week or last more than 2 days. A tricyclic antidepressant is the drug of choice for prophylaxis.

Analgesics↗
PubMed1990

Treatment of osteoporosis. What is the role of calcium?

On the basis of currently available information, the following recommendations can be made for treating osteoporosis. Women with no contraindications should maintain a total calcium intake of 1,000 mg daily before menopause and 1,500 mg daily after menopause. Calcium supplementation should be considered adjunct treatment in postmenopausal women and those who already have osteoporosis. At menopause, women with no contraindications should be given the option of taking estrogen to prevent osteoporosis. Vitamin D supplementation up to the recommended dietary allowance should be used in patients who may not get adequate dietary intake or sunlight exposure. Calcium carbonate should be the main calcium supplement when possible, because it is usually the least expensive and has the highest percentage of calcium. In older patients, who may have achlorhydria, calcium carbonate should be taken with food or another form of calcium that is well absorbed should be used. In compliant patients, calcium supplements should be given in two or three divided doses. Until more is known about exercise and osteoporosis, low-intensity exercise that promotes cardiovascular fitness should be prescribed. One appropriate regimen is brisk walking for 1 hour three times a week.

Calcitonin↗
PubMed1986

Office care of the premature infant.

The family physician should follow the small premature infant in the neonatal intensive care center and review the baby's problems and risk factors. In the office, special attention is required in monitoring the infant. Proper hospital and office care greatly improve the prognosis.

Anemia↗
PubMed1982

Infant nutrition.

Explore the source record for details and available documents.

Breast Feeding↗