A5074707271- Viral gastroenteritis research and epidemiology
- Emergency and Acute Care Studies
- Child and Adolescent Health
- Sepsis Diagnosis and Treatment
- Child Nutrition and Feeding Issues
- Food Security and Health in Diverse Populations
- Renal function and acid-base balance
- Infant Nutrition and Health
- Respiratory Support and Mechanisms
- Clinical Nutrition and Gastroenterology
- Electrolyte and hormonal disorders
- Animal health and immunology
- Pneumonia and Respiratory Infections
- Poisoning and overdose treatments
- Respiratory viral infections research
- Influenza Virus Research Studies
- Child Nutrition and Water Access
- Infant Health and Development
- Healthcare Policy and Management
- Helicobacter pylori-related gastroenterology studies
- Disaster Response and Management
- Education and Critical Thinking Development
- Trauma and Emergency Care Studies
- Bacterial Infections and Vaccines
- Gastrointestinal motility and disorders
University of Rochester
1998-2014
University of Rochester Medical Center
2000-2006
Strong Memorial Hospital
2002
May Institute
2000
Academic Pediatric Association
2000
Johns Hopkins University
1986-1998
Weatherford College
1998
Johns Hopkins Medicine
1990-1997
Indian Health Service
1997
Mead Johnson (United States)
1997
Several conjugate vaccines against Haemophilus influenzae type b have been developed in the search for one that induces protection even young infants. We evaluated safety and efficacy of a vaccine links H. capsular polysaccharide to outer-membrane protein complex (OMPC) Neisseria meningitidis serogroup B. conducted double-blind, placebo-controlled trial Navajo infants, who are at high risk systemic infections caused by b. The infants were randomly assigned receive first dose or placebo 42 90...
Objective: To examine the epidemiology of pediatric patient visits to emergency departments (ED). Methods: We conducted a cross-sectional study ED at participating Pediatric Emergency Care Applied Research Network (PECARN) hospitals in 2002. provide descriptive characteristics and comparison database National Hospital Ambulatory Medical Survey (NHAMCS). Bivariate analyses were calculated assess associated with hospital admission, death ED, length visit. also performed multivariate regression...
Objective. To identify potential barriers to the use of oral rehydration therapy (ORT) by pediatric practitioners. Design. Cross-sectional, anonymous, self-administered survey physicians' ORT knowledge, attitudes, and practice. Setting. A national continuing medical education conference. Participants. One hundred four general pediatricians primarily in private practice (66%) who completed training after 1980 (76%). Measurements results. Most respondents (83%) reported that plays an important...
To compare the use of rice-based oral rehydration solution (R-ORS), with introduction food immediately after ("early feeding"), using standard glucose-based (G-ORS) in management acute diarrhea, we conducted a four-cell randomized, controlled trial among 200 hospitalized Egyptian infants between 3 and 18 months age. During phase (first 4 hours), three groups were given G-ORS fourth group was R-ORS. subsequent maintenance phase, control soy-based, lactose-free formula (G-ORS+SF), second...
<h3>Background</h3> Parent and caregiver opinions on the feasibility of routine influenza vaccinations for infants toddlers are unknown. <h3>Objective</h3> To assess among English-speaking caregivers children aged 6 to 23 months about childhood vaccination potential knowledge, attitudinal, demographic factors that might influence such opinions. <h3>Methods</h3> A structured, interviewer-administered survey attitudes, beliefs vaccine parents at ambulatory pediatric clinic or emergency...
The American Academy of Pediatrics (AAP) recommends oral rehydration therapy (ORT) for management uncomplicated childhood gastroenteritis with mild-moderate dehydration. However, ORT is widely underused relative to their recommendations. We compared use by directors Pediatric Emergency Medicine (PEM) fellowship training programs AAP recommendations, and sought identify barriers ORT.Mail/fax survey the U.S. Canadian PEM programs. included 10 scenarios mild or moderately dehydrated children...
To understand patterns of decision making among families presenting to a pediatric emergency department (ED) for nonacute care and ED staff responses.Cross-sectional qualitative study using in-depth interviews, direct observations, nonidentifying demographic data.Eleven percent visits made during the period were identified as nonacute. All by from low-income areas. Three main themes emerged: (1) most had been referred their primary providers; (2) complexity living in areas makes choice...
For the purpose of reducing social and economic burden imposed by common acute childhood illness, we developed a telemedicine model to enable diagnosis treatment illness episodes presenting in pediatric office settings. The study objective was assess effectiveness this replacing visits traditional healthcare settings compare (base model) with that alternative models including simple laboratory tests albuterol administration (simple or complete complement procedures (extended model). Eligible...
Background The global pandemic of Coronavirus infectious disease 2019 (COVID-19), caused by SARS-CoV-2, has plunged the world into both social and economic disarray, with vaccines still emerging a continued paucity personal protective equipment; also highlighted potential for rapid emergence aggressive respiratory pathogens need preparedness. Avian immunoglobulins (IgY) have been previously shown in animal models to protect against new infection mitigate established when applied...
Palliative care remains underutilized in the United States. This may represent failure of translation research into practice (diffusion innovation). Qualitative methods can identify barriers to and facilitators diffusion innovation. The aim is potential inpatient palliative utilization at a large urban hospital, as articulated by health professionals. Rapid ethnographic assessment were used among professionals with subsequent extraction predominant themes illuminating factors influencing...
<h3>Background</h3> Influenza vaccination effectively reduces influenza-related morbidity in children but is underused. The pediatric emergency department a potential intervention point for increasing influenza children. <h3>Objective</h3> To assess the effectiveness of department–based program. <h3>Design</h3> A prospective, randomized, controlled clinical trial. <h3>Participants</h3> We recruited subjects from persons seeking care at large tertiary hospital during season 2002. Eligible...
The introduction of a soy-based, lactose-free formula during the acute phase diarrheal illness in infants has been shown to reduce stool output and duration diarrhea hospitalized patients. In United States, most with are treated as outpatients. present study, who were outpatients randomly assigned receive either alternating oral rehydration solution from beginning therapy ("early feeding") or alone for first 24 hours therapy, followed by (control group). Twenty-nine early-feeding group 27...
Primary Study Objective: Determine the frequency of abnormal fecal biomarker test results in patients with 13 irritable bowel syndrome (IBS)—related ICD-9 (International Statistical Classification Diseases and Related Health Problems) codes. Design: Quantitative review de-identified records from whom IBS was a possible diagnosis. Methods: Records were selected for analysis if they included any IBS-related diagnostic codes laboratory testing all biomarkers interest. Data collection restricted...
Low-acuity (LA) use of emergency departments (EDs) is often viewed as misuse or abuse. We designed a program to help users access services more efficiently. Community health workers (CHWs) functioned educators, screeners, and liaisons care. A participatory curriculum emphasized medical problems. Qualitative ethnographic methods were used for formative evaluation. Ninety families received regular visits from CHWs. Original system-oriented objectives did not fit community needs. Instead,...
Background: Human norovirus (HuNoV) is the leading viral cause of diarrhea, with GII.4 as predominant genotype HuNoV outbreaks globally. However, new genogroup variants emerge periodically, complicating development anti-HuNoV vaccines; other prophylactic or therapeutic medications specifically for disease are lacking. Passive immunization using oral antibodies may be a rational alternative. Here, we explore feasibility avian immunoglobulins (IgY) preventing infection in vitro human...
Acute gastroenteritis is a leading cause of visits to physicians among children in the United States. Oral rehydration therapy has prevented or reversed dehydration millions developing countries. Although most U.S. health care providers are familiar with oral therapy, its proper use still not widespread industrialized nations. Viral pathogens diarrheal illness can destroy absorptive cells at intestinal villous tip while leaving secretory intact. takes advantage remaining intact cells, less...
Ciprofloxacin was used successfully in a neonate with ventriculitis caused by multiply resistant strain of Enterobacter cloacae. Limited pharmacokinetic data indicated that adequate concentrations drug could be attained cerebrospinal fluid.
Primary Study Objective: To evaluate the economic utility of a fecal biomarker panel structured to suggest alternative, treatable diagnoses in patients with symptoms irritable bowel syndrome (IBS) by quantifying, comparing, and contrasting health service costs between tested non-tested patients. Design: Retrospective, matched cohort study comparing direct medical for IBS undergoing testing those control subjects. Methods: We examined de-identified pharmacy claims large American benefit...
Testing for urinary excretion of capsular polysaccharide antigen was carried out in 40 four-month-old Navajo infants who had received injections a Haemophilus influenzae type b Neisseria meningitidis outer membrane protein conjugate vaccine (PedvaxHIB®; Merck, Sharp and Dohme Research Laboratories) as part an ongoing efficacy trial the vaccine. Urine from 12 placebo recipients also analyzed. samples were collected on day injection (the first voided urine following injection) 3, 7, 10, 14, 21...
To obtain social and cultural data about factors affecting the development of Emergency Medical Services for Children (EMS-C) in La Paz, Bolivia. The points-of-view potential consumers providers were sought.A Rapid Assessment Procedure (RAP) was conducted. RAP is a qualitative ethnographic technique that permits delineation social, cultural, behavioral themes population based on members' lived experience. In-depth interviews participant-observation provide rapid information enhance...