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Biomedical subjects

E B Charney

Publications and source records attributed to E B Charney.

27 records · Page 2Linked to original sources
PubMed1983

Myelomeningocele newborn management: time for parental decision.

We retrospectively reviewed a process whereby parents were afforded additional time to decide the initial managements of their newborn with myelomeningocele. Of 110 newborn referrals, 52 (47%) had early surgery within the first 48 hours, 32 (29%) had delayed surgery between 3-7 days, 12 (11%) had late surgery from 7 days to 10 months, and 14 (13%) had no surgery, per parental request. There were no significant differences among the early, delayed or late surgery groups in mortality where 92%, 94% and 100% respectively were alive at 10 months, or the morbidity of worsening paralysis, ventriculitis or developmental delay. Our data suggest, therefore that there is no urgency or emergency for surgical intervention in the initial management of newborns with myelomeningocele. Rather, there is time to fully discuss issues with parents and obtain a better-informed consent for or against surgical management.

Decision Making↗
PubMed1982

Children with brain tumor headaches. Distinguishing features.

We analyzed the history, physical examination findings, and skull roentgenograms of 72 children with headaches secondary to brain tumors to determine distinguishing features. Of 56 children, skull roentgenograms were abnormal in 54% (30). Abnormal findings from either the neurologic or ocular examination were present in 68 (94%) of these children at the time of brain tumor diagnosis. These abnormalities developed in 51 of 60 children (85%) within two months of the onset of their headaches. Clues for earlier diagnosis were frequently present in those patients whose conditions were diagnosed more than four months after the onset of their headaches. Recognition of those findings could have resulted in the diagnosis of brain tumor in 69 of 72 children (96%) within four months of the onset of headaches. During the first four months of headache complaints, children should be monitored closely.

Adolescent↗
PubMed1981

Linear growth in a population of children with myelomeningocele.

Short stature or total body length less than the third percentile for age was present in 51% of our children with myelomeningocele. It was particularly common in children with higher spinal lesions where 77% of the children with L3 and higher lesions had length measurements less than the 3rd percentile for age. None of the children with sacral lesions was of short stature. Associated musculoskeletal deformities of the spine, hips, and knees made total body length and upper to lower body segment ratio measurements both difficult to obtain and less than ideal parameters for assessing linear growth. Arm span measurements, however, were easily obtained in or out of braces and were greater than expected for length in 91% of children with short stature older than 3 years of age. This apparent sparing of arm span in many of our children makes it a valuable growth parameter when assessing linear growth and in turn an important diagnostic tool for the monitoring of total health in a population of children with myelomeningocele.

Adolescent↗
PubMed1979

Computerized tomography in infantile encephalitis.

Although computerized tomographic (CT) findings are well recognized in numerous neurologic diseases of children, CT scan abnormalities of encephalitis have only been associated with herpes simplex infection. We describe two infants, one with coxsackievirus B2 meningoencephalitis and one with clinical encephalitis, whose CT scans were similarly abnormal during the acute phase of their illness. In both infants, recovery of both neurologic and developmental deficits was accompanied by resolution of the abnormalities of the initial CT scan. Speculation is offered as to the role of the CT scan in the assistance of the physician who must evaluate both the diagnosis and prognosis of infants who have a clinical picture of encephalitis.

Coxsackievirus Infections↗
PubMed1979

Kyphectomy in myelodysplasia.

The techniques used and results obtained in the surgical treatment of the kyphotic deformities of fourteen patients with paraplegia and myelomeningocele are presented. The best results were obtained by vertebral resection at the apex of the deformity, wiring together the facing vertebrae to promote interbody fusion, and correction and maintenance of the realignment with a Harrington distraction rod.

Child↗
PubMedDate not supplied

Bridging the gaps for teaching of behavioral and developmental issues in residency training.

In 1978, the Task Force on Pediatric Education identified the teaching of developmental and behavioral issues as being deficient in pediatric resident training. As subsequent attempts have been made to address these deficiencies in resident curriculum, there has often been conflict and confusion over what are the best teaching approaches and strategies. This Ambulatory Pediatric Association Workshop, therefore, attempted to identify how developmental and behavioral issues could be best taught. Results from a multicenter questionnaire identified the most useful educational technique as being direct resident involvement in the patient care of children with developmental and/or behavioral problems. This was best accomplished in the outpatient resident continuity clinic. Participants in the workshop concluded that both developmental and behavioral issues could be best taught by a general pediatrician who could function as a generalist, developmentalist and behavioralist while exemplifying high standards of patient care, teaching and research. There was considerably strong consensus among workshop participants that for any curriculum in developmental and behavioral pediatrics to succeed, there must be active support and commitment from the chairman of department of pediatrics.

Behavioral Sciences↗
PubMedDate not supplied

Community ambulation by children with myelomeningocele and high-level paralysis.

It has frequently been noted that high-level paralysis precludes community ambulation for children with myelomeningocele. Of the 87 children in our population with high-level paralysis, however, 45 (52%) did achieve community ambulation by 5 years of age, while 42 (48%) did not. There was no significant difference between these two groups by sex, shunt status, scoliosis, or hip surgery prior to 5 years of age. Among the community ambulating group, there were significantly (p less than 0.001) more children who were not retarded, had received physical therapy for walking, and had compliant parents. We concluded, therefore, that community ambulation is a realistic goal for many children with myelomeningocele and high-level paralysis.

Adolescent↗