Medicine and Health Sciences Commons^™

Occupational Therapy Sensory Integration Protocol For Early Intervention: Birth To Three Years, Reagan Boyson

Occupational Therapy Capstones

No abstract provided.

Association Of Viral Genome With Graft Loss In Children After Cardiac Transplantation., Girish S. Shirali, J Ni, R E. Chinnock, J K. Johnston, G L. Rosenthal, N E. Bowles, J A. Towbin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The survival of recipients of cardiac allografts is limited by rejection, lymphoproliferative disease, and coronary vasculopathy. The purpose of this study in children who had received heart transplants was to evaluate the cardiac allografts for myocardial viral infections and to determine whether the presence of viral genome in the myocardium correlates with rejection, coronary vasculopathy, or graft loss.

METHODS: We enrolled heart-transplant recipients 1 day to 18 years old who were undergoing evaluation for possible rejection and coronary vasculopathy. Endomyocardial-biopsy specimens were evaluated for evidence of rejection with the use of standard criteria and were analyzed for the presence …

Accessory Cell Defect In Unresponsiveness Of Neonates And Aged To Polysaccharide Vaccines., Subbarao Bondada, H Wu, D A Robertson, R L Chelvarajan

Microbiology, Immunology, and Molecular Genetics Faculty Publications

T independent antigens elicit antibody responses in the absence of carrier specific T helper cells but require signals from accessory cells (macrophages and dendritic cells) or specific cytokines. They are further subdivided into TI-1 and TI-2 categories based on the ability of TI-1 but not TI-2 antigens to elicit immune responses from neonates. Most bacterial polysaccharides including the pneumococcal polysaccharide vaccines belong to the TI-2 class. It is hypothesized that defects in accessory cell function play a critical role in the failure of neonates to respond to such TI-2 antigens. Immune responses to these TI-2 stimuli are also reduced in …

The Use Of Neuromuscular Electrical Stimulation In The Gait Training Of Children With Cerebral Palsy: A Literature Review, Rachel Rolfson

Physical Therapy Scholarly Projects

Cerebral palsy is a common developmental disorder that causes a wide array of problems in the population. The manifestations of cerebral palsy commonly interfere with the child's activities of daily living, including the important function of gait. It is therefore important that physical therapists be knowledgeable about the various treatment options used in gait training of children with cerebral palsy, as well as their effectiveness.

Neurodevelopmental techniques (NDT), neurosurgical interventions, and orthotics are just a few of the numerous treatment options available for the gait training of children with cerebral palsy. Neuromuscular Electrical Stimulation (NMES) has recently become a popular …

Physical Activity: Essential Component In Primary And Secondary Curricula For Lifelong Health, Maril Mccord

Physical Therapy Scholarly Projects

Chronic disease, preventable illness and injury, and growing trends of sedentary behaviors have currently been associated with the American population. It is estimated that 70% of all deaths in America are attributable to chronic disease of a preventable nature. Childhood disease has declined only to be replaced by new waves of social, environmental, and behavioral factors which manifest as health risks. At least 68 million Americans suffer from some form of heart disease while nearly 60% of adults lead sedentary lifestyles. The challenge in the nation is to counter these trends by implementation of policy and programs for healthier habits …

Global Cns Gene Transfer For A Childhood Neurogenetic Enzyme Deficiency: Canavan Disease., Paola Leone, Christopher G Janson, Scott J Mcphee, Matthew J During

Department of Neurosurgery Faculty Papers

The neurogenetic prototypic disease on which we chose to test our gene therapy strategy is Canavan disease (CD). CD is an autosomal recessive leukodystrophy associated with spongiform degeneration of the brain. At present the disease is uniformly fatal in affected probands. CD is characterized by mutations in the aspartoacylase (ASPA) gene, resulting in loss of enzyme activity. In this review, recent evidence is summarized on the etiology and possible treatments for CD. In particular, we discuss two gene delivery systems representing recent advances in both viral and liposome technology: a novel cationic liposome-polymer-DNA (LPD) complex, DCChol/DOPE-protamine, as well as recombinant …

A Comparison Of The Use Of Tympanic, Axillary, And Rectal Thermometers In Infants, Russell Wilshaw, Renea L. Beckstrand, Dawn Waid, Bruce Schaallje

Faculty Publications

This study examined the relationship between three instruments used in measuring tympanic, axillary, and rectal temperatures in infants less than 1 year of age. Temperatures were measured by Oto-temp Pedi Q tympanic thermometers, Becton Dickinson axillary thermometer, and rectal thermometers. A convience sample of 5 infants less than 90 day and 54 greater than 90 days with fever, as well as 34 infants less than 90 days and 27 infants greater than 90 days without fever were studied. Correlations of infants less than 90 days and greater 90 days of age, as well as differences between infant temperature with and …

Home Observation For Asymptomatic Coin Ingestion: Acceptance And Outcomes. The New York State Poison Control Center Coin Ingestion Study Group., Gregory P. Conners, D J. Cobaugh, R Feinberg, R Lucanie, T Caraccio, C M. Stork

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To obtain preliminary estimates of the acceptance rate and the frequency of adverse outcomes, and to identify issues related to acceptance, associated with management of asymptomatic pediatric coin ingestion by home observation, in preparation for a large-scale prospective study.

METHODS: Scripted telephone follow-up of callers who had reported asymptomatic pediatric coin ingestions to one of five poison control centers six to 36 months previously, which had been managed by home observation.

RESULTS: Of the 67 callers enrolled, 41 (67%) reported contacting a physician regarding the coin ingestion, despite home observation instruction by poison control center personnel. Those who did …

Nebulized Nitroglycerin In Children With Pulmonary Hypertension Secondary To Congenital Heart Disease, Hatim Omar, Fangqi Gong, Mei Y. Sun, Stanley Einzig

Pediatrics Faculty Publications

Pulmonary hypertension continues to be a major cause of morbidity and mortality, despite new treatments. Since inhaled nitric oxide has been reported to be effective in some cases, we investigated using nebulized nitroglycerine to treat pulmonary hypertension in children with congenital heart disease. Four children (ages 6-72 months) with severe pulmonary hypertension secondary to congenital heart disease (all with membranous ventricular septal defect, undergoing cardiac catheterization) were given 3 cc of nebulized normal saline over 10 min as placebo control, followed by nebulized nitroglycerine (20 micrograms/Kg in 3 cc normal saline). Normal saline administration did not elicit any change, but …

Cutaneous Malignant Melanoma, S. Sitawarin, N. Voravud, J. Vipakool

Chulalongkorn Medical Journal

No abstract provided.

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

Isolation Of Lautropia Mirabilis From Oral Cavities Of Human Immunodeficiency Virus-Infected Children, S. N. Rossmann, P. H. Wilson, J. Hicks, B. Carter, S. G. Cron, C. Simon, C. M. Flaitz, G. J. Demmler, W. T. Shearer, M. W. Kline

Faculty, Staff and Student Publications

Lautropia mirabilis, a pleomorphic, motile, gram-negative coccus, has been isolated from the oral cavities of 32 of 60 (53.3%) children infected with human immunodeficiency virus (HIV) and 3 of 25 (12.0%) HIV-uninfected controls; the association of L. mirabilis isolation with HIV infection is significant (P < 0.001). All children in the study, both HIV-infected children and controls, were born to HIV-infected mothers. The presence of this bacterium was not associated with clinical disease in these children. The HIV-infected children with L. mirabilis did not differ from the HIV-infected children without L. mirabilis in immunological status, clinical status, or systemic medications. The role of HIV infection itself or concomitant factors in the establishment of L. mirabilis in the oral cavity remains to be elucidated.

Video Of Adapted Techniques To Overcome The Physical Deficits Of Children With Visual Impairments, Amy Skalsky

Physical Therapy Scholarly Projects

Blindness is a disability with far reaching effects. Many of these effects are physical and can be seen clinically in children who have been blind for much, or all, of their lives. As physical therapists, we have the technical skills to assist in reducing the effects of the functional deficits that are associated with blindness. However, we are often unaware of these deficits, or have trouble adapting our treatment techniques to fit the needs of children who are blind or have visual impairments.

The purpose of this study is to provide a video that will demonstrate techniques that are specially …

Predicting Red Blood Cell Transfusions In Very Low Birth Weight Infants Based On Clinical Risk Factors., David A. Paul, Stephen A. Pearlman, Kathleen H. Leef, John L. Stefano

Department of Pediatrics Faculty Papers

OBJECTIVE: To describe the clinical factors most predictive of red blood cell transfusion in very low birth weight (VLBW) infants.

STUDY DESIGN: Retrospective review of VLBW infants cared for at a single level III NICU during a two year period, n = 199.

RESULTS: Overall transfusion requirement was 4.6 +/- 6.2 transfusions/infant/hospital course. Length of hospital stay, days of mechanical ventilation, requirement for dopamine support, birth weight, initial hematocrit, periventricular leukomalacia and necrotizing enterocolitis all independently correlated with number of transfusions and donors. Bronchopulmonary dysplasia and patent ductus arteriosus were associated with donor but not transfusion number.

CONCLUSIONS: Our data …

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …

A Literature Review And Introductory Pediatric Aquatic Therapy Manual, Dena Wright

Physical Therapy Scholarly Projects

Aquatic therapy continues to grow as an acceptable and often times preferable means of achieving therapeutic goals across a variety of patient populations: pediatric to geriatric, orthopedic to neurologic. The unique properties of water allow people to exercise and to recover in a safe and relaxing environment that promotes similar goals to those on land. However, land exercises can not simply be performed in water due to the water's unique properties. Similarly, exercises for adults do not work as effectively for children. Many physical therapy programs across the nation provide only minimal instruction on aquatic or pediatric therapy as a …

Dietary Influences And Exposure To Cigarette Smoke On Myringotomy Rates Of Infants, Melanie Eller Thompson

MSN Research Projects

Breastfeeding has been identified as a protective measure to defend against infection, while cigarette smoking is linked with increasing the risk of infection. The purpose of this research was to determine if there is a relationship between dietary influences and exposure to cigarette smoke on myringotomy rates of infants. The Betty Neuman Systems Model was the theoretical framework which guided the study. The researcher, using a correlational ex post facto study design, sought an answer to the question: Is there a relationship between dietary influences and exposure to cigarette smoke on myringotomy rates of infants? A convenience sampling of 128 …

Ventricular Remodeling Following Infant-Pediatric Cardiac Transplantation. Does Age At Transplantation Or Size Disparity Matter?, Girish S. Shirali, F Lombano, W L. Beeson, D A. Dyar, N F. Mulla, A Khan, J K. Johnston, R E. Chinnock, S R. Gundry, A J. Razzouk

Manuscripts, Articles, Book Chapters and Other Papers

Early left ventricular (LV) remodeling following pediatric cardiac transplantation has not been described. To identify patterns and determinants of change in left ventricular mass and volume posttransplant, we studied 125 consecutive children who underwent cardiac transplantation between January 1, 1989 and July 31, 1993. Two-dimensional imaging-directed M-mode echocardiograms were studied weekly until 26 weeks post-transplant. LV mass and volume (indexed to BSA1.5) were measured. LV mass index increased until 3 weeks post-transplant, and then decreased. The mean decrement in LV mass index after 8 weeks post-transplant (relative to baseline) was significantly larger in patients with donor-recipient weight ratio > 1.5 compared …

Images In Clinical Medicine. Bilateral Femur Fractures., Gregory P. Conners, D W. Ochsenschlager

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Comparison Of Cytotoxic Properties Of Neonatal And Adult Neutrophils And Monocytes And Enhancement By Cytokines., E . R. Stiehm, R. L. Roberts, B. J. Ank, S. Plaeger-Marshall, N. Salman, L. Shen, M. W. Fanger

Dartmouth Scholarship

We studied cytotoxic capabilities of newborn polymorphonuclear leukocytes (PMNs) and monocytes and their enhancement by cytokines and antibodies. Umbilical cord PMNs were assessed for their ability to kill various target cells spontaneously, after activation with phorbol myristate acetate, in the presence of antiserum (antibody-dependent cellular cytotoxicity), and in the presence of dually specific antibody (heteroantibody-mediated cytotoxicity). Target cells included the K562 cell line (natural killer cell target), chicken erythrocytes (CRBCs), and herpes simplex virus-infected CEM cell lines. Newborn PMNs were equivalent to adult PMNs in their cytotoxic capacity in several cytotoxicity assays. Neither adult nor newborn PMNs lyse tumor cell …

A Clustering Of Childhood Meningococcal Disease: A Challenge For Physicians, Press And Community., Michael S. Dreyer, Stephen C. Eppes, Joel D. Klein

Department of Pediatrics Faculty Papers

The Delaware Division of Public Health reported only two cases of documented meningococcal infection in the pediatric population in 1992. As of March 1, 1993, the Morbidity and Mortality Weekly Report indicated only one case of meningococcal disease in the state of Delaware for 1993. However, from the end of February to early April 1993, approximately six weeks, there were seven cases of documented meningococcal infection in the pediatric population that either presented or were transferred to one of the pediatric care facilities in the Wilmington, Delaware area. Notification of these cases to the Delaware Division of Public Health prompted …

Occupational Therapy In Early Intervention: A Family-Centered Approach., Roseann C. Schaaf, L L. Mulrooney

Department of Occupational Therapy Faculty Papers

This article describes a framework for occupational therapy service provision in early intervention settings and presents pilot data aimed at examining the framework's effectiveness. The Family-Centered Framework for Early Intervention is a synthesis of concepts from the Model of Human Occupation (Kielhofner & Burke, 1980) and from the literature on play. It encompasses a systematic, holistic approach that considers the child and the family within the context of their life environments. In this framework, play is used both as an evaluative tool and as an intervention modality that addresses the volition, habituation, and performance of the child and family as …

Characteristics Of Low Risk Women Who Experience Infant Mortality, Linda S.' Forte'

MSN Research Projects

This research study described the relationship of risk factors associated with high rates of infant m ortality and age in mothers who have experienced the death o f th e ir infants. The research question which guided this study was what is the relationship of stim u li, focal, contextual, or residual, to mothers who have experienced the death of th e ir infants and are classified as eith er high or low risk as determined by age? The Forte' Questionnaire was administered to 20 subjects selected from health departments in two Northwest Alabama counties. The sample was 70% black …

Relationship Of Family Cohesion And Adaptability To Infant Caretaking Role Patterns Of Rural Black Grandmothers And Their Adolescent Daughters, Sonja Kerlen

MSN Research Projects

This descriptive study e x p l o r e d the r e l a t i o n s h i p between family structure and infant caretaking role patterns in multigenerational rural Black families that included an adolescent mother, her infant, and the grandmother. The variables considered in relation to family structure were family cohesion and adaptability, which were conceptualized by Olson's (1983) Circumplex Model. Smith’s (1983) model of family roles formed the basis for the conceptualization of role sharing behaviors of infant caretaking r e s p o n s i b i l i ­ …

Heterogeneity Of Clonogenic Cells In Acute Myeloblastic Leukemia., Kert D. Sabbath, Edward D. Ball, Peter Larcom, Roger B. Davis, James D. Griffin

Dartmouth Scholarship

The expression of differentiation-associated surface antigens by the clonogenic leukemic cells from 20 patients with acute myeloblastic leukemia (AML) was studied with a panel of seven cytotoxic monoclonal antibodies (anti-Ia, -MY9, -PM-81, -AML-2-23, -Mol, -Mo2, and -MY3). The surface antigen phenotypes of the clonogenic cells were compared with the phenotypes of the whole leukemic cell population, and with the phenotypes of normal hematopoietic progenitor cells. In each case the clonogenic leukemic cells were found within a distinct subpopulation that was less "differentiated" than the total cell population. Clonogenic leukemic cells from different patients could be divided into three phenotype groups. …

Intracranial Tumour In An Infant Presenting As Iron Deficiency Anaemia, Rashid Jooma, D N. Grant

Section of Neurosurgery

No abstract provided.

Oncolog, Volume 29, Number 03, July-September 1984, Jesus E. Medina Md

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Clinician Relates Thickness of Stage I Melanoma to Prognosis and Treatment
• Researcher Associates High Potassium, Low Sodium Intake with Decreased Cancer Rates
• Gene Probes Used in Leukemia Diagnosis
• MOPP Chemotherapy Proves Effective for Infants and Children with Brain Tumors