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Biomedical subjects

S Ludwig

Publications and source records attributed to S Ludwig.

144 records · Page 8Linked to original sources
PubMed1980

Cellulitis: a prospective study.

We prospectively studied 20 children, ages 2 to 12 years, seen with cellulitis. Each child had a complete blood count, a blood culture, and a culture of an aspirate from the lesion. The age of the child, the fever, and the extent of cellulitis determined whether the child was hospitalized. Outpatient antibiotic therapy was penicillin or dicloxacillin. Four children (20%) had an infection on the upper extremity: 14 (70%), the leg; 1 (5%), the forehead; and one (5%), the periorbital area. Three children (15%) had a white blood cell (WBC) count greater than or equal to 15,000 cu mm. Two were febrile. One child with a WBC count less than or equal to 15,000 cu mm was febrile. Two blood cultures (10%) were positive, both for Haemophilus influenzae. Twelve organisms were isolated from the aspirates: 8 Staphylococcus aureus (all penicillinase producing), 2 H influenzae, 1 Streptococcus pyogenes, and 1 Pseudomonas aeruginosa. Both children with H influenzae were febrile with WBC counts greater than or equal to 15,000 cu mm. Of the 17 children (85%) treated as outpatients, all but one responded. We recommend admission and cultures of the blood and an aspirate of the lesion for all facial cellulitis and treatment with oxacillin and chloramphenicol. In a truncal or extremity cellulitis, initial therapy should be directed against S aureus. If the child is febrile or the WBC count greater than or equal to 15,000 cu mm, H influenzae is a likely pathogen and thus intravenous chloramphenicol must be used after cultures are obtained.

Blood Cell Count↗
PubMed1979

Interdisciplinary education for health care professionals.

As the interdisciplinary approach to health care becomes more important, new approaches to interdisciplinary education for health professionals are needed. This article presents objectives for interdisciplinary learning and describes one such course designed to deal with the problem of child abuse.

Attitude of Health Personnel↗
PubMedDate not supplied

Teaching technical skills in pediatrics.

Technical skills are an important and difficult part of managing a very sick or injured child. However, technical procedures are more often learned from experience than practice. This article reviews a variety of technical skills and procedures commonly performed in a pediatric emergency department. Each technical procedure can be practiced using live or artificial model for simulation.

Clinical Competence↗
PubMedDate not supplied

Reporting of child abuse by prehospital personnel.

INTRODUCTION: Prehospital (EMS) personnel routinely enter patient's homes and often are the first trained persons to evaluate an ill or injured child. Therefore, it is vital for these individuals to recognize child abuse (CA), and to understand the proper procedures for reporting suspected cases. METHODS: A questionnaire was administered to prehospital care-givers participating in a seminar on pediatric emergencies. Questions were designed to test factual knowledge of CA and the correct reporting procedures, as well as to evaluate attitudes toward CA. RESULTS: There were 48 responses to the questionnaire; 34 (71%) were paramedics, the remainder were emergency medical technicians (EMTs) and/or registered nurses (RNs). Thirty-three (69%) practiced either in a rural or suburban setting. Subjects had an average of 10.8 years of prehospital emergency-care experience. Twenty-eight (58%) reported no previous training in CA. All participants understood the nature of CA, were able to identify the various forms of CA, and believed CA to be a significant problem. However, 33 (69%) did not understand the legislation that mandates reporter status, and while 27 (56%) claimed to have reported CA, only 16 (33%) had made a report either to police or to children's services workers. Of the 21 who never had reported a case of CA, 14 (67%) believed that they never had encountered an abused child. The remainder were not certain, and therefore, did not report, or thought that the hospital staff would report. CONCLUSIONS: While this subject deserves further study, it seems that many EMTs and paramedics lack a complete understanding of their role in the identification and reporting of CA. This information should be emphasized further in EMT and paramedic education, and should be reinforced through continuing education.

Allied Health Personnel↗
PubMedDate not supplied

[Monitoring kidney function during neonatal intensive care: comparison between Doppler ultrasound findings and renal function parameters].

33 neonates between 4th and 7th day of life were enrolled in the study. The data of renal Doppler sonography were compared to renal excretion parameters. In infants with respiratory distress a decrease of creatinine clearance as well as an increase of fractional sodium excretion were associated with reduced peak systolic flow velocity in the A. renalis. The results suggest the importance of the Doppler sonography in the monitoring of the renal function in the newborn intensive care.

Blood Flow Velocity↗
PubMedDate not supplied

Tumour necrosis factor-alpha promoter polymorphism in erythema nodosum.

Erythema nodosum is a common skin disease characterized by erythematous, tender subcutaneous nodules, mostly located on the lower extremities. Little is known about its pathogenesis, although a wide variety of aetiological factors (e.g. bacterial and viral infections, neoplastic diseases and drugs) have been described. Sarcoidosis, a typical granulomatous disease, often occurs in association with erythema nodosum (Loefgren syndrome). Since granulomatous diseases have been closely linked to a deregulated tumour necrosis factor (TNF)-alpha production, it was tempting to speculate whether TNF-alpha might play a role in the pathogenesis of erythema nodosum, at least in cases associated with sarcoidosis. A previously described nucleotide exchange, (G-A) at position -308 in the human TNF-alpha gene promoter, has been shown to be a major cause for enhanced TNF-alpha production. In the present report, we investigated the genomic TNF-alpha promoter region in patients suffering from EN with and without underlying sarcoidosis. Our results showed a strong correlation between the uncommon TNF A II allele and sarcoidosis-associated erythema nodosum. Patients with erythema nodosum without underlying sarcoidosis displayed a similar allele frequency compared with controls. Taken together, we provide evidence that erythema nodosum in association with sarcoidosis might be pathogenically linked to altered TNF-alpha production due to a genetic promoter polymorphism.

Base Sequence↗
PubMedDate not supplied

Can we protect children from abuse? A review of three cases.

Abused infants at risk of further abuse are not being protected for many reasons. The ability of a variety of professionals to recognize and manage abuse when it occurs is limited. The reasons for this are briefly presented. Three cases in which young infants were reinjured, one fatally, are presented. Continuing efforts to improve all parts of the child welfare system and community response system need to be made. In this way, infants at risk will be better protected in our society.

Brain Injuries↗
PubMedDate not supplied

Pediatric resuscitation.

The key to successful resuscitation in children is aggressive intervention, including oxygenation, ventilation, volume expansion, other therapies directed at the cause, and close observation before cardiorespiratory arrest occurs. Prevention of arrests will have the most important impact on improving outcome. Once an arrest occurs, meticulous attention to the ABCs of resuscitation and to advanced life support guidelines may help lower mortality and morbidity rates in these tragic circumstances.

Adolescent↗