RESUMEN

This paper argues against the use of growth hormone (GH) for small normal children ("idiopathic" short stature) with the following considerations: ethical (philosophical) grounds, cost-economic implications, and the rationale for treating normal physiological variation with a potent pharmacological agent. The author would prefer to see health and economic resources being directed to correct nutritional and environmental deprivation among underprivileged groups in preference to providing GH injections for small normal children.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Six-month-old infants were recruited at 21 centres in the UK and Ireland and randomly assigned to receive matching iron-fortified (12.3 mg/l iron) or non-fortified (1.4 mg/l iron) formula for 9 months. Infants already receiving cow's milk continued this feed. Haematological indices and iron status were evaluated at age 6 months, 9-10 months and 15 months. Four hundred and six infants entered and 302 completed the study. There were no differences between the groups for increases in weight, head circumference or length. Significant differences between the groups were observed at 15 months for haemoglobin, serum ferritin, serum iron and total iron binding capacity. Haemoglobin levels were < 110 g/l in 33% of infants fed cow's milk compared with 13% and 11% in those receiving non-iron-fortified and iron-fortified formula respectively. The corresponding figures for serum ferritin < 10 microg/l were 43%, 22% and 6%. Follow-on formula provides an acceptable vehicle for preventing iron deficiency in this vulnerable group.

Asunto(s)

RESUMEN

Since the early 1980s the reports of infection and illness associated with Escherichia coli O157:H7 have increased dramatically worldwide, and particularly in the USA, Canada and UK. The spectrum of disease varies from asymptomatic carriage to haemorrhagic colitis and haemolytic uraemic syndrome (HUS). This infection is new to Ireland, and we report on 2 cases of isolation which outline the presentation of this organism with haemorrhagic colitis and HUS.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

In this study, we investigated the relationship between coping strategy and long-term outcome from traumatic brain injury (TBI) in a sample of 72 female TBI patients an average of five years post-injury. Using cluster analytic techniques based on two subscale sets from the Ways of Coping Questionnaire-Revised (WOC-R), we derived clinically relevant cluster groups based on coping strategy and validated the groups on demographic, injury-related, and quality of life measures. Results suggested that coping strategies characterized by low overall coping and positive reappraisal were associated with relatively good outcome, while those characterized by high overall coping and a combination of self-blame and escape avoidance were associated with relatively poorer outcome. These results are similar to those obtained with male samples, but societally linked gender stereotypes may contribute to unique coping and restriction of coping strategy for female TBI patients.

Asunto(s)

RESUMEN

Fifteen children with end-stage renal failure (ESRF) were treated with continuous ambulatory peritoneal dialysis (CAPD) in the Children's Hospital Temple Street Dublin between July 1984 and December 1988. These fifteen children had 150.5 treatment months, an average of 10.03 treatment months for each child. The children grew well during CAPD at an average of 0.59 cm per month. Blood pressure control was satisfactory with five out of 15 children requiring antihypertensive treatment during CAPD. The main complications of CAPD were peritonitis and catheter related problems. These 15 children experienced 47 episodes of peritonitis during 150.5 treatment months on CAPD with an average of one episode every 3.2 treatment months. Two of these children had a very high frequency of peritonitis (16 and 13 episodes each). If we exclude them from analysis, the remaining 13 children had frequency of one episode every 5.7 treatment months. During 150.5 treatment months, ten children required catheter replacement that is one catheter every 15 treatment months. One child died of candida peritonitis and to date twelve have proceeded to renal transplantation.

Asunto(s)

RESUMEN

We report a 6-year-old boy with anti-glomerular basement membrane nephritis (Goodpasture's syndrome). Intensive treatment with plasmapheresis and immunosuppression resulted in clearance of antibody and good recovery of renal function.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Considerations of distributive justice impacting upon the provision of geriatric care and the treatment of patients with end stage renal disease (ESRD) are compared and contrasted between the U.S. and the U.K. Comparisons are drawn from differing degrees of individualist and collectivist idealogies between the two countries and analysis is further developed through use of the concepts of equity, uniformity and public accountability. Notwithstanding the predominance of an individualist ideology in the United States the provision of ESRD services is based on a collectivist format. Geriatric care and other welfare services more directly reflect the differences between collectivist and individualist ideologies in the two countries.

Asunto(s)

RESUMEN

An ethnographic study of the social and psychological experiences of antepartum and postpartum prisoners was undertaken using semistructured interviews. These data, coupled with chart review data for complications experienced by the mothers and newborns, produced the following outcomes: All subjects perceived the experience as a negative one, 20 of the 26 subjects experienced a total of 72 complications, and four of the 26 newborns experienced complications requiring hospitalization in newborn intensive care units.

Asunto(s)

Asunto(s)