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Biomedical subjects

J T Benjamin

Publications and source records attributed to J T Benjamin.

At least 19 recordsLinked to original sources
PubMed1997

Pediatric residents' telephone triage experience. Relevant to general pediatric practice?

OBJECTIVES: To describe a pediatric resident telephone triage system in a tertiary hospital and to determine its relevance to telephone experience in general pediatric practice DESIGN: An analysis of 514 telephone calls from parents of continuity clinic patients made to pediatric residents. The evaluation included: chief complaint, disposition of call, age of patient, and level of training of the resident answering the call. A comparison was made with published information about a private-practice telephone triage system. SETTING: Pediatric continuity clinic, Medical College of Georgia, Augusta. PATIENTS: Children registered in the pediatric resident continuity clinic at the Medical College of Georgia. RESULTS: The 13 most frequent reasons for calling were some of the most common problems seen in pediatric practice. The disposition of calls was as follows: 272 (53%) were given telephone advice alone, 119 (23%) were offered an appointment for the next day, and 123 (24%) were advised to come to the emergency department immediately. Disposition did not vary with residency level. Both chief complaints and disposition of calls were similar to those reported in a private-practice nurse triage system. CONCLUSIONS: Answering telephone calls in a residency telephone triage system, when combined with a curriculum that includes next-day monitoring, feedback from a preceptor, and seminar discussions focused on telephone management situations, is a valuable training experience and is relevant for residents going into private pediatric practice.

Child↗
PubMed1996

The status of pediatric surgical rotations by residents in pediatrics.

A variety of forces are reshaping the traditional relationship between physicians and their patients. One consequence of this reform movement will be increased responsibility of the pediatrician to evaluate children with surgical diseases. Pediatricians also will be encouraged to do more of the minor surgical procedures themselves. It is not clear how academic pediatric surgeons should adapt to these changes to assure that the general pediatrician is equipped with the skills to handle this increased responsibility. One obvious solution would be to have the pediatrician in training rotate on the pediatric surgery service. The authors have considered these issues at their institution, and thus became interested in learning the status of pediatric surgical rotations by pediatric house staff in this country. A survey was distributed to the 221 accredited pediatric training programs in this country, and 143 individuals responded. Only thirty-five of these programs require a rotation on pediatric surgery. Eighty-six programs offer it as an elective, but only a minority of house staff takes it. The most disturbing aspect of the survey was the 28 of the programs had required a pediatric surgical rotation in the past but had eliminated it. The most common reasons given for this action were the poor educational content of the rotation and the labor requirements of the pediatric service. Based on the survey, the authors believe that it is unlikely that mandatory rotations on pediatric surgery will be begun in pediatric training curriculums. If pediatric surgeons wish to be involved in training pediatricians, they will need to address the educational content of their electives to meet the changing educational needs of the pediatricians.

Data Collection↗
PubMed1996

Effects of CLIA '88 on the physician office laboratory: a survey of midsized pediatric practices before and after CLIA '88.

A survey of midsized pediatric groups before and after the implementation of the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) was done to determine what effects this legislation has had on pediatric office laboratory testing. The pediatric groups in the two time periods were similar in geography, numbers of doctors per group, and number of years in private practice. Despite increased administrative costs of running an office laboratory, there were no significant differences in the test menus offered (p > .05), the most commonly offered tests being streptococcal antigen test, urinalysis with microscopy, urine culture, mono spot test, automated complete blood count (CBC), and cholesterol. The numbers of these tests performed in the two time periods also did not differ significantly except for the automated CBC (mean 20/MD/month in 1990 versus 32/MD/month in 1995, p < .05). No laboratory failed inspection or incurred a fine. Although overhead has risen to comply with CLIA '88, the pediatric practices surveyed did not restrict their test menus, reduce their volume of testing, or fail inspection.

Facility Regulation and Control↗
PubMed1991

Normative data of hemoglobin concentration and free erythrocyte protoporphyrin in a private pediatric practice: a 1990 update.

Free erythrocyte protoporphyrin (FEP) and hemoglobin (Hgb) concentrations were tested in 790 children in a private pediatric office; results were compared to those obtained in 1984. Only 16 children (2%) had abnormal FEPs in 1990 compared to 76 children (9.6%) in the earlier study. The mean FEP in the normal group also decreased significantly in each age group studied. The hemoglobin concentrations were not significantly different in most of the age groups studied. Screening for iron deficiency in our pediatric practice by determining hemoglobin and FEP concentrations had a much lower yield in 1990 than in 1984.

Child↗
PubMed1989

New medical standards for Virginia's high school athletes.

Virginia physicians administering preparticipation physicals to high school athletes this fall are using the new, expanded examination form that appears in this issue. Representing multidisciplinary input and incorporating current sports medicine information, the form is designed to identify the student at high risk for injury and to evaluate for a specific sport. After a two-year pilot program conducted by the authors the new form was officially adopted by the Virginia High School League.

Adolescent↗
PubMed1984

Fatal overwhelming postsplenectomy sepsis following autologous splenic transplantation in severe congenital osteopetrosis.

We report a boy with severe congenital osteopetrosis who underwent splenectomy at age 4, with simultaneous transplantation of portions of the spleen into the anterior rectus compartments. Despite demonstrated survival and partial functioning of the splenic implants, the patient died 9 years later from an overwhelming postsplenectomy infection (OPSI). This report suggests that the presence of the amount of retained splenic tissue transplanted in this case after splenectomy ultimately provides relatively ineffective protection against OPSI in congenital osteopetrosis.

Adolescent↗