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Biomedical subjects

F A Oski

Publications and source records attributed to F A Oski.

At least 19 recordsLinked to original sources
PubMed1992

Kernicterus in preterm newborns: past, present, and future.

This historical overview of kernicterus in prematurity, from the 1950s to the present, provides a unique perspective on this clinical conundrum. Three separate periods of pediatric history are detailed in relationship to our understanding of kernicterus in the preterm newborn: (1) the pre-intensive care era (1950 to 1965); (2) the low bilirubin kernicterus era (1965 to 1982); and (3) the 1980s. Each period demonstrates selected insights regarding kernicterus in prematurity, and together with recent reports suggest that premature newborns are now at extremely low risk of developing kernicterus when managed using current standards of care. However, the current conservative empiric guidelines for preventing kernicterus are questioned, and it is suggested that additional study is needed to clarify this issue in the 1990s.

Bilirubin↗
PubMed1991

Pediatrics.

Explore the source record for details and available documents.

Child↗
PubMed1991

Attitudes and factors affecting the decisions of men and women pediatrics residents toward having children during their residencies.

This study examines attitudes and factors affecting the decisions of pediatrics residents of both sexes toward having children during their residencies. In 1987, the authors surveyed by mail all 742 pediatricians who had trained at eight university-based residencies from 1981 to 1987; 417 responded. Of these, the men were significantly more likely than the women to have had children during their residencies (p less than .001). At the time of their residencies, 265 of these pediatricians were married. Of those who were married but did not have children during their residencies (175), the women were significantly more likely than the men to believe that having a child during residency would have had a negative influence on their careers (p less than .001) and would have been associated with difficulties in arranging child care (p less than .001). By contrast, among those pediatricians who were married and did have children during their residencies (90), their perceptions concerning the impacts on their careers of having children and the difficulty in arranging child care did not differ significantly by gender. The authors suggest that programs might explore the possibilities of greater flexibility in scheduling and of making child care more available so that residents could more easily combine their careers with having children.

Attitude of Health Personnel↗
PubMed1979

RBC surface pits in the sickle hemoglobinopathies.

Functional asplenia develops in children with sickle cell anemia. This asplenia is related to the increased incidence of bacterial sepsis that has been documented in these patients. With the use of direct-interference contrast microscopy to quantitate splenic function, we studied children with the sickle hemoglobinopathies. A gradual increase in splenic dysfunction with increasing age was documented in children with homozygous sickle cell disease. Children with the sickle variants also seem to manifest degrees of splenic dysfunction. Direct-interference contrast microscopy is a simple quantitative technique for the evaluation of splenic function in children with the sickle hemoglobinopathies.

Adolescent↗
PubMed1979

Abnormal erythrocyte metabolism in hepatic disease: effect of NADP repletion.

Erythrocytes from ten patients with severe liver disease displayed low methylene blue-stimulated hexose monophosphate (HMP) shunt activity and glucose recycling despite elevated total glucose consumption when compared to controls. Heinz body formation was increased and reduced glutathione concentration significantly decreased. After hemolysis, no differences in methylene-blue estimulated HMP shunt activity or glucose recycling could be demonstrated between patients and controls. The addition of 2- and 4-mM NADP to the hemolysates produced significantly greater HMP shunt activity and glucose recycling in the patients' hemolysates. The addition of NADPH to the incubation mixture produced no significant stimulation of either HMP shunt activity or glucose recycling, unless methylene blue was also added. Omission of NAD or phosphate from the incubation mixture produced no change in shunt metabolism. The absence of supplemental ATP resulted in extremely low shunt metabolism and refractoriness to NADP stimulation in both patients and controls. In the absence of additional magnesium, a reduction of shunt metabolism was noted. These data suggest that the defect in stimulated shunt metabolism in the intact erythrocytes of patients with hepatic disease does not result from an absolute enzyme deficiency, but rather from an unavailability of NADP or other cofactor.

Adult↗
PubMed1979

A prospective randomized study to determine the efficacy of steroids in treatment of croup.

We evaluated the use of dexamethasone in the management of acute laryngotracheobronchitis (croup). Thirty patients, ranging in age from eight to 60 months, were evaluated in a prospective, double-blind study. Patients received dexamethasone, 0.3 mg/kg at the time of admission and a similar dose 2 hours later, and were compared with a placebo group receiving saline. Sixteen patients received dexamethasone and 14 patients received the placebo. Severity of each group was scored by a standardized system. Patients receiving dexamethasone had a mean admission score of 8.46 points; patients receiving placebo, 8.14. Twenty-four hours after admission the patients in the treatment group had a mean score of 1.19 as contrasted with a score of 5.58 for the placebo group (P less than 0.01). We concluded that dexamethasone when administered in adequate dosage by an intramuscular route hastens the recovery of infants and children with acute uncomplicated croup.

Child, Preschool↗
PubMed1979

Clinical implications of the oxyhemoglobin dissociation curve in the neonatal period.

Factors responsible for determining the position of the oxyhemoglobin equilibrium curve during the neonatal period are briefly reviewed and the clinical implications of these changes are examined. Two clinical trials employing exchange transfusions as an adjunct to conventional therapy of the severe respiratory distress syndrome have both demonstrated that this procedure reduces mortality. In neither study was it possible to demonstrate that the improvement was a direct consequence of the reduction in hemoglobin's affinity for oxygen that was produced by the substitution of fetal hemoglobin by adult hemoglobin. Data on the role of the position of the oxyhemoglobin equilibrium curve in the regulation of erythropoiesis during the "anemia of prematurity" demonstrate that the ability to unload oxygen is more important than the absolute hemoglobin level in both the stimulus to erythropoietin production and the clinical manifestations of anemia. The gradual shift of the position of the oxyhemoglobin equilibrium curve which occurs during the early months of life may not be sufficient in all infants to meet the growing preterm infants' metabolic needs without evoking additional cardiac compensation.

Anemia↗
PubMed1979

The mean corpuscular volume (MCV) in children with acute lymphoblastic leukemia.

Although most children with acute lymphoblastic leukemia (ALL) are anemic at the time of diagnosis, the cause of this anemia remains obscure. In an effort to characterize the anemia, we analyzed the mean corpuscular volume (MCV) at the time of diagnosis. The MCV was selected because of the observation that older erythrocytes have a reduced MCV and an anemia presumably related to decreased red blood cell production should be reflected by a reduced MCV. A total of 54 patients fulfilled the criteria for analysis. Of this group, 33 per cent had an increased MCV, 61 per cent had a normal MCV, and 6 per cent had a decreased MCV for age. Patients with an increased MCV were found to have a significantly lower hemoglobin and platelet count. The number of females in the group with the increased MCV was 83 per cent as contrasted with 43 per cent in the group with a normal MCV. At relapse, 71 per cent of patients with an initially increased MCV had an elevated MCV as contrasted with only 23 per cent in the group with an initially normal MCV. These observations suggest that in patients with ALL and an increased MCV, a maturation defect may be present that affects all cell lines and may be the result of a diffusible substance released from the leukemic cells. The MCV cannot be used as a reflection of mean cell age in patients with ALL and does not support the belief that the anemia in ALL is merely the result of a "crowding-out" process.

Adolescent↗
PubMed1979

Nutritional anemias.

The role of the metals, iron and copper, and the vitamins E, folic acid, and B12 in the genesis of nutritional anemias in infancy have been reviewed. All are preventable. The precise requirements for each of these trace elements and vitamins in the small premature infant remain to be defined. The nonhematologic consequences of these nutritional deficiencies require further study. Anemia may prove to be the least important manifestation of the deficiency states.

Adolescent↗
PubMed1979

Vitamin E and platelet function.

In both animals and humans, vitamin E deficiency is associated with platelet hyperaggregability. In six E-deficient children, thrombocytosis was associated with marked hyperaggregability of their platelets to ADP, epinephrine, and collagen. Platelet malonyldialdehyde (MDA) formation was used as an indicator of prostaglandin formation, and was found to be increased during the E deficiency state. Following E repletion, both platelet aggregation and platelet MDA formation returned to normal. The addition of vitamin E to platelets in vitro has been associated with inhibition of platelet release, aggregation, and MDA formation. Extending these in vitro observations further, six normal controls were given 1600 units of vitamin E orally daily for 2 weeks to elevate their plasma E levels and the E content of their platelets in vivo. Concomitant with the elevation in their plasma E levels, there was an inhibitory effect of 12--20% on platelet MDA formation following E ingestion. These studies suggest that E deficiency increases the in vivo synthesis of platelet endoperoxides and prostaglandins, and that E excess has the opposite effect, i.e., inhibition of the endoperoxide intermediates of prostaglandin synthesis.

Animals↗
PubMed1979

The "In-Training Examination" of the American Board of Pediatrics: does it test for "new" or "old" information?

The American Board of Pediatrics In-Training Examination or "Pre-Test" is not in widespread use as a means of evaluating the cognitive knowledge and problem-solving skills of hourse officers. The examination is modeled after the certifying examination of the American Board of Pediatrics. The 1977 Pre-Test was analyzed in an attempt to determine whether awareness of recent medical knowledge was required to pass this examination. The 7th through 10th editions of the Nelson Textbook of Pediatrics were used as a reference source. These editions represent information that is from 5 to at least 20 years of age. Analysis of the 190 items revealed that the correct answer was known for 148 or 78% of the questions at least 20 years ago. These results suggest that the Pre-Test, and presumably the American Board of Pediatrics certifying exam, measures the candidates' knowledge of long-standing core information.

Educational Measurement↗