Arch Pediat Adol Med
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Laparoscopy may offer fast recovery and improved cosmesis, but its cost has been perceived as excessive. ⋯ Laparoscopy is cost-effective, particularly for fundoplication, appendectomy, and cholecystectomy. Detailing the costs of supplies, operating time, and length of stay allows interinstitutional comparison and critical cost-analysis of laparoscopy. With a more selective use of reusable instruments and further shortening of operative time, the global savings of laparoscopy may increase.
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Arch Pediat Adol Med · Sep 1999
Clinical Trial Controlled Clinical TrialFamily presence during invasive procedures in the pediatric intensive care unit: a prospective study.
To determine if allowing 1 or both parents to be present during invasive procedures reduces the anxiety that parents experience while their child is in the pediatric intensive care unit; to evaluate if the parent's presence was helpful to the child and parent; and to determine whether this presence was harmful to the nurses or physicians. ⋯ Allowing parental presence during procedures decreases procedure-related anxiety. The implications of such a policy change on physicians and other aspects of pediatric intensive care, including medical education, need further evaluation.
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Arch Pediat Adol Med · Aug 1999
Self-inflicted and unintentional firearm injuries among children and adolescents: the source of the firearm.
The source and ownership of guns used by children to shoot themselves or others is largely unknown. ⋯ Most guns involved in self-inflicted and unintentional firearm injuries originate either from the victim's home or the home of a friend or relative.
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Arch Pediat Adol Med · Aug 1999
Internal medicine-pediatrics combined residency graduates: what are they doing now? Results of a survey.
While the number of internal medicine-pediatrics (med/peds) residency training programs has increased considerably in the past decade, questions continue to be raised about career paths of the graduates of these programs. It is uncertain whether med/peds graduates follow a generalist career path and whether they continue to practice both specialties. ⋯ This study, the largest survey to date of med/peds graduates, provides strong evidence that most med/peds graduates are practicing generalists who care for adults and children. In addition, the fact that 80% of graduates achieve dual board certification suggests that these physicians are well qualified to care for the spectrum of health care needs of children and adults. Because the changing US health care system mandates a strong primary care base, these physicians will play a small but important role in providing high-quality generalist care.
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To determine the incidence of group A beta-hemolytic streptococcus (GABHS) carriers in children who are well, in children seen with presumed and documented viral illnesses with sore throat, and in children after treatment of acute GABHS tonsillopharyngitis with 10 days of oral penicillin V potassium, oral cephalosporins, or macrolides. ⋯ A small percentage of children seen in private pediatric practices who are well or who have apparent viral upper respiratory tract infections with sore throat are GABHS carriers. Penicillin treatment of acute GABHS tonsillopharyngitis results in a higher GABHS carriage rate than occurs following treatment with cephalosporins and macrolides.