Publications by authors named "Lehr V"

Article Synopsis
  • - The study emphasizes the necessity for occupational therapists and speech-language pathologists to utilize reliable assessment tools for pediatric feeding disorder (PFD), given its complex nature across the medical, nutritional, feeding skill, and psychosocial domains.
  • - A mix of survey and focus group research with clinicians showed that 65% used nonstandardized tools, leading to themes such as the ineffectiveness of single assessments, reliance on self-created tools, and the importance of teamwork in addressing PFD.
  • - The findings indicate a critical need for enhanced education on valid assessment methodologies, as current tools lack standardization and comprehensive evaluation of all PFD domains, ultimately underscoring the call for improved practices in the field.
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Phosphorus (P) is a limiting nutrient for plants and an essential element for all life on Earth. As the resources of phosphate rock are depleting, new management tools for environmentally friendly P fertilizers are needed. In order to achieve this, recent studies have proposed to use biochar, a carbon-rich solid product of thermochemical conversion of biomass with minimal or zero oxygen supply, as slow-release P fertilizer.

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Objective: The primary aim was to determine whether watching a short video in the inpatient setting could produce an immediate improvement in pediatric patients' asthma knowledge and inhaler technique.

Methods: This prospective, quasi-experimental, pre-post study was conducted in a single center, in Detroit, Michigan, which primarily serves an urban, African-American population. Patients were eligible if they were between 8- and 16-years-old, had asthma, and would be discharged with an albuterol metered-dose inhaler.

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Patients with cystic fibrosis (CF) have chronic and progressive lung infections with various bacterial organisms that require treatment with oral and intravenous antibiotics on a regular basis. Trimethoprim-sulfamethoxazole (TMP-SMX) is one of the medications used to treat acute pulmonary infectious exacerbations in patients with CF. Hepatic toxicity secondary to TMP-SMX was previously described in normal subjects but has not been reported in children with CF.

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To characterize and compare acid suppression (pharmacodynamics) and pharmacokinetics of IV famotidine and ranitidine in critically ill children at risk for stress gastritis. Single-blind, randomized study in PICU patients 6 months to 18 years requiring mechanical ventilation with continuous gastric pH monitoring, randomized to IV famotidine 12 mg/m(2) or ranitidine 60 mg/m(2) when gastric pH < 4.0 >1 hour with serial blood sampling following first dose.

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Critically ill newborns in neonatal intensive care units (NICUs) are at greater risk of developing adverse drug reactions (ADRs). Differentiation of ADRs from reactions associated with organ dysfunction/immaturity is difficult. Current ADR algorithm scoring was established arbitrarily without validation in infants.

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Objectives: To compare pharmacy students' performance on an objective structured clinical examination (OSCE) to their performance on a written examination for the assessment of problem-based learning (PBL); and to determine students' and faculty members' perceptions of OSCEs for PBL evaluations.

Design: Four OSCEs were added to the written examination to assess 4 PBL cases in a third-year pharmacotherapy course. OSCE scores were compared to written examination scores.

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High-dose inhaled tobramycin has been increasingly used for treatment and suppression of Pseudomonas aeruginosa pulmonary infections, especially in patients with cystic fibrosis. The advantage of inhalation over other routes of administration is minimal systemic absorption, which reduces the potential for adverse effects. However, cases of adults who had elevated serum concentrations and experienced systemic adverse effects due to excessive systemic absorption after inhaled tobramycin have been reported.

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During the past two decades there has been a substantial increase in the number and types of topical anesthetics available. Options for the prevention of neonatal pain associated with skin-breaking procedures were previously limited to injections of lidocaine hydrochloride. Topical anesthetics are now available as creams, gels, and a heat-activated patch system.

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Objective: To determine the relations between Neonatal Facial Coding System (NFCS) scores and measures of infant crying during newborn circumcision.

Methods: Video and audio recordings were made of infant facial activity and cry sounds, respectively, during the lysis phase of circumcisions of 44 healthy term males (<3 d of age). All infants received topical analgesia before circumcision.

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Background: Intrauterine growth retardation (IUGR) results in substantial decrease in nephron number and renal and hepatic organ mass in experimental animals and newborn infants. Because the liver and the kidneys are the major organs for drug biotransformation and elimination, any decrease in their size and function may lead to impaired metabolism and elimination of drugs in newborns with IUGR. Our objective was to test the hypothesis that IUGR results in prolonged renal elimination of vancomycin in newborns.

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Background: Endotracheal intubation and mechanical ventilation are major components of routine intensive care for very low birth weight newborns and sick full-term newborns. These procedures are associated with physiologic, biochemical, and clinical responses indicating pain and stress in the newborn. Most neonates receive some form of analgesia and sedation during mechanical ventilation, although there are marked variations in clinical practice.

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Background: Preterm and full-term neonates admitted to the neonatal intensive care unit or elsewhere in the hospital are routinely subjected to invasive procedures that can cause acute pain. Despite published data on the complex behavioral, physiologic, and biochemical responses of these neonates and the detrimental short- and long-term clinical outcomes of exposure to repetitive pain, clinical use of pain-control measures in neonates undergoing invasive procedures remains sporadic and suboptimal. As part of the Newborn Drug Development Initiative, the US Food and Drug Administration and the National Institute of Child Health and Human Development invited a group of international experts to form the Neonatal Pain Control Group to review the therapeutic options for pain management associated with the most commonly performed invasive procedures in neonates and to identify research priorities in this area.

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Objective: The purpose of this article is to summarize the clinical, methodologic, and ethical considerations for researchers interested in designing future trials in neonatal analgesia and anesthesia, hopefully stimulating additional research in this field.

Methods: The MEDLINE, PubMed, EMBASE, and Cochrane register databases were searched using subject headings related to infant, newborn, neonate, analgesia, anesthesia, ethics, and study design. Cross-references and personal files were searched manually.

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This study evaluated the efficacy and safety of lidocaine 4% cream (LMX4), compared with lidocaine 2.5% and prilocaine 2.5% (EMLA) or dorsal penile block (DPNB) for analgesia during circumcision.

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Neonates are at increased risk of injury from infiltration of intravenous fluids because of small vessel size and immature skin structure. Until recently, hyaluronidase injection was used to prevent tissue injury following the infiltration of intravenous solutions in neonates. The production of hyaluronidase injection was discontinued in 2001.

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Patient-controlled analgesia (PCA) has been widely implemented to provide better pain relief and increased patient satisfaction with relatively few side effects. However, patients using intravenous (i.v.

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Pediatric patients benefit from patient-controlled analgesia (PCA), which eliminates the need for painful intramuscular injections of opioids and improves the child's sense of control. Age is often used inappropriately as a criterion for PCA use in children. Children must be carefully screened for their cognitive and physical ability to manage their pain using PCA.

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Objective: To report a case of high transdermal fentanyl dosage requirements in a patient with chronic cancer pain.

Data Sources: Clinical studies, review articles, and relevant laboratory information.

Case Summary: A 42-year-old woman with cervical cancer was admitted for control of her pain.

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Objective: To report a case of hepatic failure in a patient who was receiving oral ciprofloxacin.

Data Sources: Case reports, review articles, and relevant laboratory studies identified by MEDLINE.

Data Extraction: Data were abstracted from pertinent published sources by one author and reviewed by the remaining authors.

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Correlations between obesity and prognosis of operated cancer of the breast have not been investigated until now. In 491 patients operated upon by radical mastectomy (1968 to 1972) it can be demonstrated that in patients in whom the weight of the resected breast is above 1100 g the survival rates are more unfavourable than in other cases. As to tumor size and invasion of lymphnodes the distribution in the group with "heavy breasts" is more unfavourable than in the other groups.

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