Early high-frequency oscillatory ventilation versus synchronized intermittent mandatory ventilation in very low birth weight infants: a pilot study of two ventilation protocols.

Objective: To evaluate the feasibility of conducting a prospective, randomized trial comparing early high-frequency oscillatory ventilation (HFOV) to synchronized intermittent mandatory ventilation (SIMV) in very low birth weight (VLBW) premature infants. This pilot study evaluated two ventilator management protocols to determine how well they could be implemented in a multicenter clinical trial. Although this pilot study was not powered to detect differences in outcome, we also collected outcome data.

Physician assessment of patient motivation: influence on disposition for follow-up care.

This study of 3,318 outpatient visits evaluated the influence of the physician-assessed level of patient motivation on the level of physician involvement in follow-up care. Data collected included patient demographics, health risk factors, physician-assessed level of patient motivation, and the disposition for follow-up care (return office visit or self-care). Physicians more frequently scheduled patients for a return office visit, regardless of assessed level of patient motivation, when they presented with a traditional biomedical problem.

Family practice residents' identification and management of obesity.

This study, involving 25 family practice residents and 2746 patients in a family practice residency programme, addressed four hypotheses regarding the identification and management of obesity in the primary care setting: (i) the physician-identified prevalence of obesity is significantly lower than the actual prevalence in the population, (ii) obesity is more likely to be addressed with management actions when it is recorded on the medical record problem list than when it is not recorded, (iii) physician actions dealing with obesity are influenced by the patient's age, sex, level of motivation, and body mass index (BMI) value, and (iv) the type of physician management actions taken are affected by the patient's age, sex, level of motivation, and level of BMI value. Obesity was identified as a risk factor by physicians for 51.6% of all patients with a BMI greater than or equal to 30.

Unintentional injuries. Risk factors in preschool children.

Successful strategies for preventing childhood injuries require better understanding of injury epidemiology. A case-control study was designed to identify risk factors for injury among preschool patients of a university-affiliated, community-based family practice center. Thirty-four children who were injured during a 1-year period and 36 age- and sex-matched controls were included.

Administrative skills for academic physicians.

To function effectively within the multifaceted environment of the academic medical center, academic physicians need to heighten their understanding of the economics of the health care system, and further develop their leadership and managerial skills. A literature base on organizational development and management education now exists that addresses the unique nature of the professional organization, including academic medical centers. This article describes an administration development curriculum for academic physicians.

Administrative skills for academy physicians.

To function effectively within the multifaceted environment of the academic medical center, academic physicians need to heighten their understanding of the economics of the health care system, and further develop their leadership and managerial skills. A literature base on organizational development and management education is now available, which addresses the unique nature of the professional organization, including academic medical centers. This article describes an administration development curriculum for academic physicians.

Fatal aspiration of a makeshift pacifier.

A case is presented of an infant who aspirated the nipple from a makeshift pacifier. The use of makeshift pacifiers is widely practiced at hospital nurseries throughout the United States and should stop immediately.

Giant cystic choristoma of the head and neck in a neonate: successful management of a life-threatening respiratory emergency.

Cervical choristoma is a rare tumor of the head and neck. Definition of the embryology of this unusual lesion and review of the literature concerning it suggests that its usual location can cause life threatening airway obstruction. A successfully managed case of a giant congenital choristoma is presented.

Depressed skull fracture in the neonate. Report of three cases.

The authors describe three cases of neonatal depressed skull fracture that were elevated by means of an obstetrical vacuum extractor. In one case, a transparent breast pump shield replaced the metal vacuum extractor cup, permitting direct observation as the depression was elevated. Neonatal depressed skull fractures not associated with neurological signs may be safely elevated without surgery using the obstetrical vacuum extractor.