Biomedical subjects

M J Corwin

Publications and source records attributed to M J Corwin.

22 records · Page 2Linked to original sources

PubMed1986

Efficacy of oral antibiotics for the treatment of persistent otitis media with effusion.

We followed 137 children who were found to have persistent otitis media with effusion (POME) one month after the diagnosis of acute otitis media. Subjects were randomly assigned to either treatment with erythromycin ethylsuccinate and sulfisoxizole or to no treatment. Follow-up utilizing pneumatic otoscopy and tympanometry showed that treated patients were more likely to have normal findings, and less likely to develop acute otitis media during the month following treatment. These data indicate that children with POME one month following acute otitis media may benefit from an additional course of antibiotics.

Administration, Oral↗

PubMed1982

Infant cry: a clue to diagnosis.

It has been postulated that the infant cry is a reflection of complex neurophysiologic functions and that analysis of the infant cry can be utilized to assess the infant's status. To test this hypothesis a model of cry production was developed utilizing a computer-based signal processing system that enabled the observer to relate closely the acoustic properties of the cry to the anatomic and physiologic characteristics of the infant producing the cry. The cries of 87 infants were analyzed following a standardized pain stimulus. Cry features were grouped into eight evaluative tests. Only seven of 55 apparently normal term infants had the abnormality "glottal instability" whereas 11 of 12 infants with bilirubin values in the 10 to 20 mg/100 ml range displayed the glottal instability pattern. An additional group of 17 infants with a variety of problems was studied; 14 of 17 displayed two or more abnormalities, and ten of 12 infants with respiratory disease had a unique pattern. Of particular interest was the finding of acoustical features suggestive of a constriction in the vocal tract in three infants; two of these infants were studied prospectively and subsequently were victims of sudden infant death syndrome and the third had a sibling with recurrent apnea. These results suggest that the analysis of the infant cry holds promise for detecting a number of abnormalities and may prove valuable as screening test to detect infants at risk for sudden infant death syndrome.

Acoustics↗

PubMedDate not supplied

Factors associated with the transition to nonprone sleep positions of infants in the United States: the National Infant Sleep Position Study.

CONTEXT: Studies have demonstrated strong associations between the prone sleep position (on the stomach) and sudden infant death syndrome (SIDS). In 1992, the American Academy of Pediatrics recommended that infants be placed to sleep laterally (on their side) or supine (on their back) to reduce SIDS risk, and in 1994, the national public education campaign "Back to Sleep" was launched. OBJECTIVE: To determine the typical sleep position of infants younger than 8 months in the United States, the changes that occurred after these recommendations, and the factors associated with the placement of infants prone or supine. DESIGN: Annual nationally representative telephone surveys. SETTING: The 48 contiguous states of the United States. PARTICIPANTS: Nighttime caregivers of infants born within the last 7 months between 1992 and 1996. Approximately 1000 interviews were conducted per year. MAIN OUTCOME MEASURES: The position the infant was usually placed in for sleep, and the position the infant was most commonly found in when checked during the night's sleep. RESULTS: Ninety-seven percent of respondents in each wave of the survey usually placed their infant to sleep in a specific position. Infants were placed in the prone position by 70% of caregivers in 1992, prior to the campaign, but only 24% in 1996. Supine and lateral placements increased during this time period, from 13% in 1992 to 35% in 1996 and from 15% in 1992 to 39% in 1996, respectively. Significant predictors of prone placement included maternal race reported as black (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.68-3.26), mother's age 20 to 29 years (OR, 1.28; 95% CI, 1.09-1.50), region reported as the mid-Atlantic (OR, 1.41; 95% CI, 1.12-1.78) or southern states (OR, 1.47; 95% CI, 1.22-1.70), mothers with a previous child (OR, 1.68; 95% CI, 1.43-1.97), and infants younger than 8 weeks (OR, 0.63; 95% CI, 0.46-0.85). Infants aged 8 to 15 weeks were significantly more likely to be placed nonprone over time compared with the other age groups. Most of the risk factors for prone were significantly related in the opposite direction to supine placement. CONCLUSIONS: The prevalence of infants placed in the prone sleep position declined by 66% between 1992 and 1996. Although causality cannot be proved, SIDS rates declined approximately 38% during this period. To achieve further reduction in prone sleeping, efforts to promote the supine sleep position should be aimed at groups at high risk for prone placement.

Guidelines as Topic↗

PubMedDate not supplied

Changes in sleep position during infancy: a prospective longitudinal assessment.

CONTEXT: Prone sleeping by infants has been associated with an increased risk of sudden infant death syndrome. OBJECTIVE: To document the prevalence of and identify risk factors for prone sleeping during the first 6 months of life. DESIGN: Prospective cohort study. SETTING: Eastern Massachusetts and northwest Ohio. STUDY PARTICIPANTS: A total of 7796 mothers of infants weighing 2500 g or more at birth. MAIN OUTCOME MEASURES: Maternal and infant characteristics related to prone sleeping at 1 month and 3 months of age. RESULTS: Between 1 month and 3 months of age, prone sleeping increased from 18% to 29%. At 1 month, prone sleeping was associated with the following maternal characteristics: non-Hispanic black or Hispanic race/ethnicity, younger age, less education, and higher parity. At 3 months, switching from nonprone to prone position was associated with mother's race/ethnicity of non-Hispanic black (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.3) or Hispanic (OR, 1.5; 95% CI, 1.1-2.2); younger maternal age (compared with mothers >34 years: 18-24 years, OR, 1.6; 95% CI, 1.2-2.2; <18 years, OR, 2.2; 95% CI, 1.2-4.3); increasing parity (compared with 1 child: 2 children, OR, 1.5; 95% CI, 1.2-1.8; > or =3 children, OR, 1.7; 95% CI, 1.4-2.2); and infant sex (male sex, OR, 1.4; 95% CI, 1.2-1.7). CONCLUSIONS: If infant sleeping practices in the study communities are representative of practices throughout the United States, a substantial number of infants who slept nonprone at 1 month sleep prone at 3 months.

Adult↗