Abstract:
:Presenting characteristics, long-term outcome, and techniques used in the diagnosis of 143 infants with suspected biliary obstruction are reviewed. Sixty-nine patients had surgically confirmed extrahepatic disease and 74 had intrahepatic disorders. A disproportionate number of infants with intrahepatic disease were boys (p = 0.013), low birthweight (p = 0.001), or had siblings with liver disease (p = 0.017). An initial total bilirubin of 20 mg/dl or greater was rare except in the intrahepatic disease category of neonatal hepatitis of known cause (p = 0.006). The initial percutaneous liver biopsy correctly predicted the ultimate diagnosis in 94 percent of all 143 patients. A methodological outline to diagnosis is presented, emphasizing early recognition of symptoms and careful follow-up with hepatobiliary imaging, liver biopsy, and surgical exploration, if required, until definitive diagnosis is made. This approach has aided us in reducing the age of diagnosis of biliary atresia from 12.8 +/- SD 7.3 weeks during the period 1971 through 1979 to 6.8 +/- SD 2.6 weeks from 1980 to 1982 (p = 0.0015). Eighteen-month survival has improved from 25 to 60 percent.
journal_name
Clin Pediatr (Phila)journal_title
Clinical pediatricsauthors
Ferry GD,Selby ML,Udall J,Finegold M,Nichols Bdoi
10.1177/000992288502400601subject
Has Abstractpub_date
1985-06-01 00:00:00pages
305-11issue
6eissn
0009-9228issn
1938-2707journal_volume
24pub_type
杂志文章abstract::Topical application of ocular drugs may cause serious adverse ocular or systemic side effects. Children are at greater risk for systemic side effects because ocular dosing is not weight-adjusted, and infants are especially vulnerable as a consequence of the inability to efficiently metabolize the drug, and/or an immat...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280404300114
更新日期:2004-01-01 00:00:00
abstract::A 12-year-old girl presented with weakness, diplopia, and lethargy after a prodrome of gastroenteritis. Laboratory studies were compatible with a diagnosis of hemolytic uremic syndrome. She developed seizures that were controlled by diphenylhydantoin and valium. In spite of peritoneal dialysis and fresh frozen plasma ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288702601208
更新日期:1987-12-01 00:00:00
abstract::Families of 49 hearing-impaired children responded to a questionnaire requesting information about the identification of their child's hearing loss. Parents were the first to suspect the hearing loss in 48 cases but more often than not were told that the child would outgrow it or was too young to test. When profession...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289103000202
更新日期:1991-02-01 00:00:00
abstract::When dealing with the management of the dying patient and his family, systematic research has been very limited. Understanding the dying child's needs, as well as his family's, is important for approprirate therapy programs. The present study investigated the mother's awareness of her child's expressed and wanted need...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992287701600207
更新日期:1977-02-01 00:00:00
abstract::Rotavirus gastroenteritis primarily affects children younger than 5 years of age and is the leading cause of diarrhea-related hospitalizations worldwide. The substantial morbidity associated with this disease and the major burden on healthcare resources underscore the need for an effective vaccine. Two recently develo...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922808314903
更新日期:2008-07-01 00:00:00
abstract::Osteoporosis causes significant morbidity for boys with Duchenne muscular dystrophy. Corticosteroid therapy given to prolong mobility may increase the rate of osteoporosis and risk of fracture. This study of 33 boys with Duchenne muscular dystrophy determined retrospectively the incidence of vertebral fractures partic...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280304200408
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To identify factors that might influence physicians' referrals of obese adolescents to pediatric multidisciplinary weight management (PMWM) programs. DESIGN/METHODS:Survey of a national sample of 375 pediatricians (PDs) and 375 family physicians (FPs) explored program availability, referral history, desired ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922810368287
更新日期:2010-09-01 00:00:00
abstract::To understand why congenital dislocated hip (CDH) was diagnosed late (mean age: nine months) in children admitted to the Children's Hospital of Philadelphia (CHOP), 714 consecutive CHOP admissions, aged zero to two years, and 947 consecutive newborns delivered at the Hospital, University of Pennsylvania (HUP) were exa...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992287601500304
更新日期:1976-03-01 00:00:00
abstract::Patients with selective IgA deficiency, the most common primary immunodeficiency, occasionally may undergo spontaneous recovery. In this paper we present three additional children whose IgA levels spontaneously returned to normal. All three presented with gastrointestinal symptoms, and one child also had frequent uppe...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288202100202
更新日期:1982-02-01 00:00:00
abstract::The Parent Attitudes about Childhood Vaccines (PACV) survey for identifying vaccine-hesitant parents was recently validated in Washington State but did not include all recommended childhood vaccines. The current study compares vaccination rates for all recommended childhood vaccines and PACV scores at one pediatric pr...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922815615823
更新日期:2016-06-01 00:00:00
abstract::The authors administered an abbreviated revision of a previously field-tested, self-administered, brief screening test (the 30-item Drug and Alcohol Problem Quick Screen) to 355 consecutive middle-class adolescent patients seen at a five-pediatrician group practice setting. Ninety-six percent (341) of the subjects com...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289002900106
更新日期:1990-01-01 00:00:00
abstract::An 8-year-old girl with Hallermann-Streiff syndrome (oculomandibulofacial syndrome) was examined. She had a history of severe snoring, reported nocturnal apnea, excessive daytime hypersomnolence, nocturnal enuresis, and failure to thrive. Overnight polysomnography confirmed severe obstructive sleep apnea. Long-term na...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289002900212
更新日期:1990-02-01 00:00:00
abstract::Using questionnaires, administrative claims, and chart review data, the current study explored the impact of using an electronic medical record system to administer, score, and store the Pediatric Symptom Checklist (PSC-17) during annual pediatric well-child visits. Within a sample of 1773 Medicaid-insured outpatients...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922819892038
更新日期:2020-02-01 00:00:00
abstract::This study was conducted to determine if culture confirmation is needed for a negative rapid antigen detection test. Data on 18,509 tests done in patients younger than 18 years old were reviewed. Of the 14,167 (76.5%) that were negative, 968 (6.8%) were associated with positive cultures. No significant seasonal variat...
journal_title:Clinical pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1177/0009922806290219
更新日期:2007-04-01 00:00:00
abstract::Neisseria meningitidis is an important cause of fulminant septicemia and meningitis in children. Only limited reports of mild disease associated with this organism exist. In this study, we describe eight children, ages 2.5-19 months, with mild meningococcal disease and characterize the meningococcal isolates from some...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288502401101
更新日期:1985-11-01 00:00:00
abstract::Knowledge of the characteristics of family structure may be helpful to the pediatrician for predicting child abuse. During the past several decades progressive shifts from the classic family unit of two biological parents and their children to a variety of parental living arrangements have occurred. Most notable are t...
journal_title:Clinical pediatrics
pub_type: 杂志文章,评审
doi:10.1177/000992280604500201
更新日期:2006-03-01 00:00:00
abstract::Clinic-based social needs screening has been associated with increased access to social services and improved health outcomes. Using a pragmatic study design in an urban pediatric practice, we used logistic regression to identify factors associated with successful social service uptake. From December 2017 to November ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922820908589
更新日期:2020-06-01 00:00:00
abstract::Three cases are presented which illustrate the possible difficulties in differentiating between the diagnoses of Guillain-Barre Syndrome and conversion disorder. Accepted criteria are specified for each condition, as well as some associated features often characteristic of similar cases. Supportive interdisciplinary t...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289103001002
更新日期:1991-10-01 00:00:00
abstract::Cefotaxime, a third generation cephalosporin antibiotic, was evaluated in 26 infants and children for the treatment of documented or suspected bacterial infections, including pneumonia (10 cases), soft tissue skin infection (13 cases), and urinary tract infection (3 cases). An average daily dose of 60 mg/kg in 3 to 4 ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288402300406
更新日期:1984-04-01 00:00:00
abstract::With an incidence of 1 in 3,000, neurofibromatosis type 1 (NF1), or von Recklinghausen disease, is one of the most common genetic disorders encountered by primary care physicians. NF1 is a multisystem disease that affects more than one million people worldwide (more than 80,000 in the United States). Although most ped...
journal_title:Clinical pediatrics
pub_type: 杂志文章,评审
doi:10.1177/000992289603501101
更新日期:1996-11-01 00:00:00
abstract::We analyzed findings from the 2009-2010 National Survey of Children with Special Health Care Needs to identify associations between families with children and youth with special health care needs (CYSHCN) reporting adequate care coordination (CC) with family-provider relations, shared decision making (SDM), and child ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922818783501
更新日期:2018-10-01 00:00:00
abstract::This article, Part 2 of a five-part series on The Web, Communications Trends, and Children's Health, describes how the Web's "virtual library" lets pediatricians tap into an evergrowing body of resources, including the latest medical information and online Continuing Medical Education. In addition, the Web creates new...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289803700401
更新日期:1998-04-01 00:00:00
abstract::Of 1045 children admitted with gastroenteritis over a 12-month period and studied retrospectively, serum sodium level was tested in 802. Sixty patients (7.5%) had hypernatremic dehydration (HD). The peak incidence of HD, the highest serum sodium levels, and the worst outcome were all encountered in infants under the a...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992288402300501
更新日期:1984-05-01 00:00:00
abstract::In this retrospective case series, we report clinical factors associated with pediatric peritonsillar abscess (PTA), with hopes of contributing to the design of an evidenced-based, economic treatment approach. Charts were examined for presenting symptoms and signs. Each of these were analyzed for association with the ...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922818778048
更新日期:2018-10-01 00:00:00
abstract::We conducted a cross-sectional study to evaluate timeliness of patient arrival at a pediatric multispecialty clinic. Bivariate and ordered logistic regression analyses were conducted to determine the odds of late arrival by specified patient- and visit-level characteristics. A total of 64 856 visits were available for...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922816672450
更新日期:2017-06-01 00:00:00
abstract:INTRODUCTION:Well child care is taught with individual visits in pediatric residency. Teaching residents how to deliver well child care efficiently is critical. Group well child care brings multiple families together for visits. The authors piloted group visits in pediatric residency clinic. METHODS:The authors conduc...
journal_title:Clinical pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1177/0009922811417289
更新日期:2012-02-01 00:00:00
abstract::Premature delivery is common in pregnancies complicated by maternal diabetes. However, the outcome of very-low-birth-weight infants (VLBWI) born to mothers with diabetes is not known. Employing a matched double-cohort design, we investigated the influence of maternal diabetes on the outcome of VLBWI born in Winnipeg f...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992280204100705
更新日期:2002-09-01 00:00:00
abstract::Although still considered to be a rare and mostly fatal illness, the reported incidence of neonatal bacterial endocarditis has increased during the past decade. This parallels the establishment of intensive supportive management of severely ill newborns with multiple medical problems. An extremely difficult diagnostic...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/000992289002900707
更新日期:1990-07-01 00:00:00
abstract::Although copper deficiency is a rare occurrence in the developed world, attention should be given to the proper supplementation of minerals to at-risk pediatric patients. This study presents 3 distinct cases of copper deficiency in hospitalized patients aged 14 months, 6 years, and 12 years. Two patients had short bow...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922812446743
更新日期:2012-08-01 00:00:00
abstract::We conducted a retrospective study to identify electrocardiogram (ECG) and echocardiogram utilization among patients presenting for a follow-up cardiology evaluation with innocent heart murmur between 2012 and 2014. The 2014 echocardiogram Appropriate Use Criteria was applied. We observed high rates of ordering ECGs a...
journal_title:Clinical pediatrics
pub_type: 杂志文章
doi:10.1177/0009922818787280
更新日期:2018-10-01 00:00:00