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Biomedical subjects

J M Chamberlain

Publications and source records attributed to J M Chamberlain.

16 recordsLinked to original sources
PubMed1995

Pediatric coin ingestion: a home-based survey.

To improve understanding of the natural history of pediatric coin ingestions, an anonymous, home-based mail survey of parents followed by a five-physician private pediatric practice in suburban Maryland was conducted. Of 2,263 families surveyed, 798 (35.3%) responded, representing 1,510 children. Sixty-one (4.0%, 95% confidence interval: 3.1% to 5.1%) children had swallowed a coin, at a mean age of 2.8 years. Fifty-two (85%) coin ingestions were managed at home, usually without calling a physician or poison control center. Only 9 (15%) children were examined by a physician. No child (95% confidence interval: 0% to 4.9%) underwent a removal procedure or had an adverse outcome. Most coin ingestions were found to have been managed at home, often without calling a physician or poison control center. Hospital- or poison control center-based studies underestimate coin ingestion incidence and overestimate the frequency of complications.

Adolescent↗
PubMed1992

Silver nitrate burns following treatment for umbilical granuloma.

Three infants treated for umbilical granuloma with silver nitrate suffered chemical burns to the periumbilical area which prompted visits to the emergency department. Treatment was conservative, and the outcome was good in all cases. We recommend caution when applying silver nitrate to the umbilicus, careful drying of the umbilical exudate to prevent spillage, and discussion with parents that burns may occur but apparently are not serious. The possibility of secondary infection is discussed.

Burns, Chemical↗
PubMed1992

Prospective randomized double-blind study comparing L-epinephrine and racemic epinephrine aerosols in the treatment of laryngotracheitis (croup).

Aerosolized racemic epinephrine, but not L-epinephrine, is commonly used in treating croup. The efficacy and adverse effects of nebulized racemic and L-epinephrine in the treatment of laryngotracheitis were compared. Children 6 months to 6 years of age with a croup score of 6 or above were assigned in a randomized double-blind fashion to receive either racemic (n = 16) or L-epinephrine (n = 15) aerosols. Croup score, heart rate, blood pressure, respiratory rate, fraction of inspired oxygen, and oxygen saturation were recorded before treatment and at 5, 15, 30, 60, 90, and 120 minutes after the aerosol. Patients in both groups showed significant transient reduction of the croup score and respiratory rate following the aerosol (P less than .001), but there were no differences between treatment groups when croup score, heart rate, blood pressure, and respiratory rate were assessed over time. It is concluded that L-epinephrine is at least as effective as racemic epinephrine in the treatment of laryngotracheitis and does not carry the risk of additional adverse effects. L-Epinephrine is also more readily available worldwide, is less expensive, and can be recommended for this purpose.

Aerosols↗
PubMed1991

Follow-up: who needs it?

The ability of pediatric residents to appropriately assign patients to receive follow-up has not previously been studied. We independently reviewed 1693 consecutive charts of patients presenting to the pediatric emergency department. The authors agreed with 60 of the 82 resident-assigned follow-ups and identified 99 patients who should have been assigned to receive follow-up but were not (missed follow-ups). When compared with the group appropriately assigned to receive follow-up care, the missed follow-up group was similar in sex, type of insurance, and time of presentation but tended to be younger and was significantly different in terms of mean temperature and health care provider. In regard to the latter, the missed follow-up group had a lower mean temperature and more often had an identifiable routine health care provider. Young age and respiratory difficulty were the factors contributing most to the authors' assignment as a missed follow-up. Specific formal teaching directed at the appropriate use of follow-up for outpatients should be incorporated into pediatric residency training curricula.

Acute Disease↗
PubMed1991

Comparison of a tympanic thermometer to rectal and oral thermometers in a pediatric emergency department.

We performed a clinical trial of a new tympanic thermometer to test its accuracy in a pediatric emergency department. Tympanic temperature was compared to oral or rectal glass and electronic temperature, depending on the developmental age of the child. Results were controlled for age of the child, cooperation, quantity of cerumen, and the presence or absence of otitis media. Our results suggest good correlation of tympanic with oral and rectal glass thermometry except in infants less than three months of age. Sensitivity and specificity, respectively, were 80% and 93% for detecting fever of 38 degrees C and 80% and 95% for detecting fever of 38.5 degrees C.

Adolescent↗
PubMed1988

Occult bacteremia in children with simple febrile seizures.

The controversy surrounding the diagnostic workup for simple febrile seizures has centered around the lumbar puncture. This focus has obscured the potential importance of other tests. A retrospective study was performed to determine the frequency of occult bacteremia in simple febrile seizures. In a pediatric emergency department, we identified 115 cases of simple febrile seizures in children treated as outpatients. Blood cultures were performed in 93 (81%) of 115 patients; five (5.4%) were positive. Children were less likely to have blood cultures performed if they were older than 24 months or had a medical history of simple febrile seizures. However, neither age nor history of febrile seizures affected the risk of bacteremia. These data suggest that patients with simple febrile seizures are at approximately the same risk for bacteremia as children with fever alone. Patients with simple febrile seizures should be treated in the same manner as other patients of the same age with regard to the performance of blood cultures.

Child↗
PubMed1984

Which prescriptive screening programmes are worth while?

Prescriptive screening is defined as screening for diseases solely for the benefit of the individuals participating in the programme. Currently used screening programmes are examined at each stage of life-antenatal, postnatal, school age, adult life, and old age. It is concluded that most disorders for which screening can be confidently recommended for the benefit of the individual are those occurring in children: screening infants for phenylketonuria, hypothyroidism, visual and auditory impairment, and probably congenital dislocation of the hip. Subject to parents' informed consent to participate, antenatal screening for Down's syndrome and neural tube defects is effective in high risk populations. Screening programmes to detect in school children visual and auditory defects and dental diseases are worth while. Two major problems arise in most programmes--firstly, how to achieve a high compliance rate of the population in attending for screening and accepting subsequent treatment; secondly, how to determine what treatment, if any, should be offered to borderline cases. Further evaluation of these problems is required for many programmes.

Adolescent↗
PubMed1978

The treatment of smoking as a self-defeating behavior.

This study (n = 18 men and women) sought to determine whether (a) the Eliminating Self-Defeating Behaviors Workshop would help smokers significantly decrease their smoking behavior, (b) this decrease would be maintained for four weeks, and (c) the Rotter I-E Scale could predict which smokers would show the most significant decrease and maintain this reduction. The results indicated that members of the experimental group made significant decreases in their smoking rates (p less than .001) and maintained this reduction for four weeks. The experimental group also made significant changes toward more internal locus of control at the conclusion of the workshop (p less than .10) but did not maintain this change at the four-week follow-up. The Rotter I-E Scale was unable to predict which individuals would show the most significant decrease in smoking rate and maintain this reduction.

Behavior Therapy↗
PubMed1975

Eliminating self-defeating behaviors and change in locus of control.

This study investigated changes in locus of control occurring among participants in a workshop designed to eliminate self-defeating behaviors. Experimental (n = 18) and control (n = 18) groups were composed of male and female university students. An analysis of covariance indicated that the treatment group moved significantly more than the control group (p less than .001) on the Rotter I-E Scale, and movement was in the anticipated direction, toward greater internal control. The increased internal control was maintained in a follow-up administration of the I-E Scale four months later. It was concluded that the workshop brought relatively stable changes toward greater perceived internal control. Implications were discussed.

Adaptation, Psychological↗