Search PubMed⌕ Search

Biomedical subjects

J S O'Shea

Publications and source records attributed to J S O'Shea.

At least 19 recordsLinked to original sources
PubMed1996

Cardiovascular effects of cocaine in neonates exposed prenatally.

This blinded cross-sectional study was to determine whether chronic cocaine exposure in utero produces abnormalities in left ventricular function (shortening fraction), heart rate, rhythm, and conduction in term neonates. Three groups of neonates were evaluated by two-dimensional echo Doppler and 24 hour Holter monitor, with studies initiated in the first 24 hours of life. Group A (n = 32) neonates had a positive history of chronic maternal cocaine use in pregnancy (MCU+) and a positive neonatal urine cocaine test (NUC+). Group B (n = 23) neonates were MCU+ but NUC-. Group C (n = 32) neonates were MCU- and NUC-. Measured parameters were compared statistically by analysis of variance. p < 0.05 was regarded as significant. Echocardiography showed no significant difference between groups A, B, and C for left ventricular shortening fraction. Holter monitor likewise revealed no significant difference between groups in minimal, maximal, and average heart rate, or in the incidence of supraventricular and ventricular arrhythmias greater than 20 beats/h in the 24-hour period. None of the patients had atrioventricular or bundle branch block. It is possible that the developmental state of the newborn heart makes it less responsive to the adverse effects of cocaine.

Analysis of Variance↗
PubMed1991

House-fire and drowning deaths among children and young adults.

House fires and drownings remain frequent causes of pediatric and young adult mortality and morbidity, yet have received less attention than other causes of injury to the young. To investigate the gender, racial and socio-economic components of these problems, as well as the contribution of chronic disabilities, all deaths in a single state over a 7-year period in the birth through 24-year-old population were studied. Females and males overall had no appreciable differences in house-fire mortality. Females from birth through age 4 were more at risk, however, than older females of dying in house fires, but did not appear at more risk than males of the same age. Nonwhite males under age 4 were much more at risk than white males. Nonwhite females compared similarly to white females, both in the birth through 4-year age range, as well as in the overall population studied. Males had more drowning deaths overall than females, with most of the difference attributable to a large male predominance in the 15- through 24-year age group. Furthermore, males in this age group were much more likely to drown than were younger males. Both males and females in this age group were at particular risk if they had a past history of seizures. No other gender or racial differences could be determined, either in the overall population or in the separate age groups, except in victims greater than 4 years of age many more deaths were found in the lower three socio-economic quintiles than in the higher two.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Risk of infectious complications in well-appearing children with transient neutropenia.

To determine whether well-appearing children found incidentally to be neutropenic are at risk for an infectious complication, 44 consecutive months of hematology laboratory records were reviewed. One hundred nineteen patients had medical record documentation regarding clinical course, serial white blood cell counts, and the absence of serious infections, chronic illnesses, or a family history known to be associated with neutropenia. The median duration of documented neutropenia was 13 days (range, 1 to 491 days). Infectious complications occurred in 4 of the 36 patients who had neutropenia for more than 30 days (2 with stomatitis, 1 with cellulitis, and 1 with pneumonia) but in none with shorter durations of neutropenia. There were no significant associations between the development of an infectious complication and either the initial absolute neutrophil count or the lowest documented absolute neutrophil count, nor was there a correlation between the initial absolute neutrophil count and the duration of neutropenia. These data indicate that infectious complications occur in otherwise well children with unexplained neutropenia that persists, but these infections are infrequent and usually are superficial.

Agranulocytosis↗
PubMed1988

Pilot evaluation of instructing parents of newborns about poison prevention strategies.

Providing new parents with both written and verbal information about poisons and with syrup of ipecac appeared to be successful when distributed at discharge of their normal newborns. New parents who received neither information nor ipecac served as controls. Distribution occurred during a nine-month period, which was followed after an interval of three months by a four-month evaluation period. The average (+/- SD) time between infant poison exposures and parent telephone calls to the statewide poison center during the evaluation period was 5 +/- 3 minutes for the subjects and 12 +/- 4 for age-matched and socioeconomically matched controls. Both groups had similar frequencies of potentially dangerous exposures for which syrup of ipecac was recommended. Subject parents appeared to have homes which in various respects were significantly more child-safe than those of the controls. Significantly more control homes contained syrup of ipecac after the exposures than before (77% vs 41%).

Health Education↗
PubMed1988

Diagnosing appendicitis in children with acute abdominal pain.

Differentiating acute appendicitis from other causes of acute abdominal pain in children frequently remains unsatisfactory. To determine whether initial historical and physical examination findings might predict final diagnoses, 246 patients with complaints of nontraumatic and nonrecurrent acute abdominal pain were studied. All were between three and 18 years of age and had presented to a hospital-based pediatric emergency department. Each family was telephoned an average of 5.1 days after the visit to determine the patient's subsequent clinical course; operative notes and pathology reports were reviewed for patients receiving surgery. Of these patients with acute abdominal pain, both fever and vomiting were present in 18 of the 24 who eventually had diagnoses of appendicitis, compared with 49 of 222 patients with other final diagnoses (P less than 0.01, with negative predictive value 0.97, sensitivity 0.75, and specificity 0.78, but positive predictive value only 0.27). The duration of the pain at presentation and the frequency of other symptoms (eg, diarrhea, dysuria, anorexia, and lethargy) were unrelated, however, to final diagnosis, as was the duration of the pain and whether abdominal tenderness initially was localized or generalized. Nonruptured appendicitis was generally indistinguishable from ruptured appendicitis preoperatively, by both duration and symptoms. Boys were found more likely to have appendicitis (with or without rupture) than girls (18/118 or 15%, vs. 6/128 or 5%, P less than 0.05). In conclusion, fever and vomiting were noted at presentation more frequently in children with appendicitis than in children with other causes of acute abdominal pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen, Acute↗
PubMed1987

The Children's Depression Rating Scale for normal and depressed outpatients.

The Children's Depression Rating Scale (CDRS) was devised by Poznanski, Cook, and Carroll in 1979, to diagnose depression in 6- to 12-year-olds. The authors state a score of 30 indicates significant depression, with scores in the 20 to 30 range indicating borderline depression. Normative outpatient data for the CDRS have not, however, been established. In this study, 25 apparently well-adjusted children from a pediatric primary care unit were evaluated by the CDRS. Their scores (ranging from 16 to 18) differed significantly from the normal values noted by the founders of the scale, based on the study of inpatients. On the other hand, a study of six of our clinically depressed children indicated scores of 22 to 49. With this definition of the normal score the outpatient child who scores greater than 20 is classified as in need of close follow up to determine if he is depressed.

Child↗
PubMed1987

Biliary cystadenocarcinoma of extrahepatic duct origin arising in previously benign cystadenoma.

A case of biliary cystadenocarcinoma arising from the common hepatic duct in a 47-yr-old woman who had two previous attempts at cure by local excision of a then-benign biliary cystadenoma is reported, adding further evidence that resection is the preferred treatment of these tumors, even when histologically benign. A review of the literature and of pertinent clinical and pathological features of the 32 previously reported cases is included.

Bile Duct Neoplasms↗
PubMed1987

Other health problems of children with acute otitis media.

To help clarify whether acute otitis media is associated with a different frequency of other health problems compared to other acute illnesses, 77 acute otitis patients (average age two years, three months) seen in a university-affiliated pediatric primary care facility were studied. Each was paired with a patient of the same age and sex who presented at the same time with another acute health problem. No differences were detected between the two sets of patients in the frequency of neonatal or prior health problems, except that the patients with acute otitis media had had more previous episodes of this condition than the other patients. At the time of presentation both sets had similar growth and socioeconomic status, and during the year after presentation no differences were noted in the type or number of health problems.

Child↗
PubMed1986

Pediatric resident management of the young febrile child.

Identifying the febrile child at risk for serious illness continues to challenge physicians, especially since conflicting guidelines exist for identification and management. This situation poses a special problem for the pediatrician-in-training. In this study the 35 PL-1, P1-2, and PL-3 pediatric house staff of a university-affiliated hospital were surveyed by written questionnaire regarding their practices in dealing with children of less than two years with rectal temperature above 101 degrees F (38.3 degrees C). Uniform replies were received from all house staff concerning the significance of patient age, degree of fever, and laboratory data, although there were some differences of opinion regarding the importance of specific data. All three resident levels tended to reduce the number of laboratory tests obtained as patient age increased, with emphasis placed on clinical impression of illness in assessing the older febrile child. Although the house staff indicated that they were satisfied with their handling of the febrile child, the PL-3s were only marginally more satisfied than the PL-1s and PL-2s. In general, the house staff had most confidence in handling the patient under three months of age, for whom it was generally felt that extensive laboratory evaluations and active management were indicated. The perception of the need for a formal protocol was also greatest for this youngest age group and decreased in importance with age.

Age Factors↗
PubMed1986

Childhood otitis media with effusion: six-year follow-up.

Twenty-five patients were re-evaluated six years after presenting with their first episode of otitis media with effusion. The average age at presentation was 6.2 years. Twenty-three were found on follow-up to have normal audiometry and tympanometry, and had improved or at least remained stable in school performance. Recurrences of acute middle ear disease were noted during follow-up in eight of the patients, specially among the six who had presented in the summer, and more frequently among the eight children who eventually had tympanostomy tubes placed. This study appears to support the concept that otherwise normal American children presenting with otitis media with effusion seem fairly uncommonly to develop severe, recurrent middle ear disease.

Acoustic Impedance Tests↗
PubMed1984

An attempt to influence health care visits of frequent hospital emergency facility users.

In this study, 445 patients under 19 years of age who visited an urban hospital emergency facility for acute illnesses four or more times over 2 years were randomly divided into two groups. The parents of 230 of the patients received three letters that stressed the value of continuous pediatric care and the lack of continuity available in emergency facilities. The letters indicated a willingness to offer advice as to how they could obtain continuing care. The remaining 215 patients served as controls. During the following year, the patients whose parents received the letters and the controls were compared in their visits to the hospital's emergency facility, primary care unit, and subspecialty clinics. Very few differences were noted between the two groups.

Acute Disease↗
PubMed1982

Childhood serous otitis media: fifteen months' observations of children untreated compared with those receiving an antihistamine-adrenergic combination.

Of 55 patients who had received, in a previously reported double-blind study, either an antihistamine-adrenergic combination or a placebo for three months for serous otitis media, 48 were followed without drug therapy for an additional year. During the follow-up period no differences were detected between the patients who had initially been treated with drugs and those who had received the placebo, as detected by audiometry, tympanometry, parental concern about hearing loss (as detected by the parents themselves or by their children's teachers or primary health care providers), school performance, or recurrences of serous otitis media.

Child↗