J Natl Med Assoc
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Randomized Controlled Trial
The pediatric resident training on tobacco project: interim findings.
The Pediatric Residency Training on Tobacco Project is a four-year randomized prospective study of the efficacy of training pediatric residents to intervene on tobacco. At the start of the study (baseline), the pediatric residents uniformly agreed that environmental tobacco smoke (ETS) and tobacco use pose serious threats to the health of young people, and pediatricians should play a leadership role in the antismoking arena. However, very few went beyond advising patients and parents to modify their behavior by providing actual assistance, and many of them lacked necessary tobacco intervention skills and knowledge. We hypothesized that both standard training and special training programs would yield positive changes in intervention skills and activities, although the changes would be greater in residents exposed to the special training condition. In the present report, we present two-year outcome data from the resident tobacco surveys and objective structured clinical examinations (OSCEs) administered to independent waves of third-year residents in each experimental condition at baseline and year 2. ⋯ The two-year findings from the pediatric tobacco project are encouraging and suggest that the special training program is efficacious, although aspects of the program in need of improvement were identified.
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To evaluate the effects of topical emollient therapy on fluid intake, urine output, serum electrolytes, glucose, bilirubin and other outcome measures of neonates < or = 27 weeks' gestational age (GA) with birthweight (BW) <1,000 g. ⋯ Infants < or = 27 weeks' gestation who had Aquaphor applied to their skin from birth required less fluids and had better urine output. These infants had lower serum potassium and bilirubin values during their first two weeks of life. Therefore, we conclude that topical Aquaphor application to thee skin is beneficial for fluid and electrolyte balance in extreme preterm infants.
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Examples from our recent experience, as well as several reports in surgical and pediatric journals, proclaim the danger in children whenever more than one swallowed magnet travels beyond the stomach. They may attract across the thin walls of small bowel, causing ischemia, necrosis and perforation into the peritoneum. The radiologist or other healthcare worker seeing magnets in the abdomen on radiographs should consider the situation an emergency and recommend surgical treatment as soon as possible.