Clinical pediatrics
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Clinical pediatrics · Nov 1988
Carving a niche--the general academic pediatrician as consultant. Part I: The referring physicians and their patients.
The role of the general pediatrician as a specialist is often unclear to the majority of physicians and patients. The role of the general academic pediatrician (GAP) as a consulting subspecialist also is in need of definition. We surveyed a consultation service staffed primarily by three GAPs in our tertiary care children's hospital. ⋯ Only 29 percent of the patients were referred to pediatric subspecialists. GAPs acting as consultants in a tertiary care setting most often see patients with long-standing complaints that do not require hospitalization or subspecialist referral, but their role at times is expanded to include more acute and more complex problems. Referrals may come from primary care physicians or from tertiary care subspecialists, particularly surgeons, or by self-referral from the patients' families.
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Clinical pediatrics · Nov 1988
Case ReportsProphylactic cryoprecipitate in congenital afibrinogenemia.
Two siblings with congenital afibrinogenemia received prophylactic infusions of cryoprecipitate in order to prevent serious hemorrhage during early childhood. Three bags (units) of this fibrinogen-containing blood product were administered every 7-10 days for 15 months in one case and 24 months in the other. ⋯ Side effects from cryoprecipitate were not observed. Prophylactic infusion of cryoprecipitate, made practical by the relatively long half-life of fibrinogen, should be considered in other patients with this disorder.