PREMATURE AND NEWBORN INFANTS

PEDIATRICS ◽  
1957 ◽  
Vol 20 (1) ◽  
pp. 143-154
Author(s):  
Richard L. Day ◽  
William A. Silverman
Keyword(s):  
New York ◽  
Early Recognition ◽  
Medical Center ◽  
Newborn Infants ◽  
Breech Presentation ◽  
County Hospital ◽  
Gastrointestinal Complications ◽  
Kings County ◽  
First Feeding ◽  
History Of

Participating in the seminar's first session were Dr. William R. Richardson, Kings County Hospital, Brooklyn, New York, who served as moderator, Dr. Thomas Santulli, Children's Surgeon at Columbia-Presbyterian Hospital, New York City, Dr. Marel H. Harmel, Anesthesiologist at Kings County Hospital, and Dr. Lawrence K. Pickett, Chief of Surgery at the State University of New York Medical Center in Syracuse. All speakers emphasized the importance of closely co-operative effort by pediatricians, surgeons, radiologists, anesthesiologists and nursing personnel to facilitate early recognition, diagnosis and effective treatment of neonatal complications requiring surgery. Diagnosis Early recognition of surgical problems usually depends upon the observations of well-trained nurses. Any history of obstetric complications especially breech presentation, a maternal history of hydramnios, any signs of respiratory distress, difficulty in swallowing at the time of the first feeding, emesis of bile-stained fluid, abdominal distention, or failure of the appearance of the first stool within 24 hours after birth should alert all observers to the possibility of complications which will require surgery. As soon as respiratory or gastrointestinal complications are suspected, Dr. Pickett requests radiologic consultation. A roentgenogram of the chest, taken at this time, will delineate not only the infant's pulmonary status, but also the gas pattern of the intestinal tract. When the clinical picture suggests gastrointestinal obstruction, Dr. Pickett and his colleagues employ a No. 8 to 10 French soft rubber catheter, specially prepared by punching several holes in its terminal 1 cm portion. This tube is inserted under fluoroscopic control and passed cautiously to avoid traumatic puncture of any obstructing tissue which may be encountered When esophageal atresia is recognized the proximal esophageal pouch is carefully aspirated to remove pooled saliva.

The Effect of a Methadone Treatment Program Upon Pregnant Heroin Addicts and Their Newborn Infants

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 300-305
Author(s):  
Rita G. Harper ◽  
George I. Solish ◽  
Henry M. Purow ◽  
Edward Sang ◽  
William C. Panepinto
Keyword(s):  
New York ◽  
Psychosocial Support ◽  
Past History ◽  
Medical Center ◽  
Methadone Treatment ◽  
Newborn Infants ◽  
Care Program ◽  
State University ◽  
Downstate Medical ◽  
History Of

A Family and Maternity Care Program (FMCP) for pregnant addicts, their spouses and the newborn infants was organized at the State University of New York Downstate Medical Center. Twenty-five percent of the women were treated for syphilis; 18% had a recurrent or recent past history of hepatitis. Obstetrical complications were reduced or eliminated by careful obstetrical surveillance. None of the mothers signed out against medical advice postpartum. Of the 51 living infants delivered within the study period, there were 17 infants weighing less than 2,500 gm. The Apgar score at one minute was 7 or higher in 84% of the infants. An excessive incidence of congenital malformation was not seen. Ninety-four percent of the infants developed withdrawal symptoms, 6% of whom convulsed repetitively. Infant withdrawal, however, was unassociated with an increase in mortality or known prolonged morbidity. This low-dose methadone program coupled with intense psychosocial support appeared to alleviate many of the common problems associated with addiction in pregnancy, but failed to prevent withdrawal in the newborn.

scholarly journals Addressing the Gaps in Preparation for Quarantine

2013 ◽  
Vol 28 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Rita Nathawad ◽  
Patricia M. Roblin ◽  
Darrin Pruitt ◽  
Bonnie Arquilla
Keyword(s):  
New York ◽  
Infection Control ◽  
Disaster Preparedness ◽  
Health Care Facilities ◽  
Lessons Learned ◽  
County Hospital ◽  
Symptom Monitoring ◽  
Kings County ◽  
Client Management ◽  
Hospital Center

AbstractIntroductionIn the event of an outbreak of a communicable respiratory illness, quarantine may become necessary. The New York Institute for All Hazard Preparedness (NYIAHP) of the State University of New York (SUNY) Downstate Medical Center, in cooperation with the New York City Department of Health and Mental Hygiene's Healthcare Emergency Preparedness Program, (NYC DOHMH-HEPP) quarantine working group, has developed a series of clinical protocols to help health care facilities respond to such an event.ProblemTwo full-scale exercises (FSEs) were designed and conducted a year apart in the quarantine unit at Kings County Hospital Center (KCHC) to test the efficacy and feasibility of these quarantine protocols. The goal of these exercises was to identify the gaps in preparedness for quarantine and increase hospital readiness for such an event.MethodsEvaluators monitored for efficient management of critical physical plants, personnel and material resources. Players were expected to integrate and practice emergency response plans and protocols specific to quarantine. In developing the exercise objectives, five activities were selected for evaluation: Activation of the Unit, Staffing, Charting/Admission, Symptom Monitoring and Infection Control, and Client Management.ResultsThe results of the initial FSE found that there were incomplete critical tasks within all five protocols: These deficiencies were detailed in an After Action Report and an Improvement Plan was presented to the KCHC Disaster Preparedness Committee a month after the initial FSE. In the second FSE a year later, all critical tasks for Activation of the unit, Staffing and Charting/Admission were achieved. Completion of critical tasks related to Symptom Monitoring and Infection Control and Client Management was improved in the second FSE, but some tasks were still not performed appropriately.ConclusionIn short, these exercises identified critical needs in disaster preparedness of the KCHC Quarantine Unit. The lessons learned from this logistical exercise enabled the planning group to have a better understanding of leadership needs, communication capabilities, and infection control procedures. Kings County Hospital Center performed well during these exercises. It was clear that performance in the second exercise was improved, and many problems noted in the first exercise were corrected. Staff also felt better prepared the second time. This supports the idea that frequent exercises are vital to maintain disaster readiness.NathawadR, RoblinPM, PruittD, ArquillaB. Addressing the gaps in preparation for quarantine. Prehosp Disaster Med. 2013;28(2):1-7.

scholarly journals 206. Clinical and Molecular Characteristics of Community-associated Staphylococcus aureus Bacteremia in Injection and Non-injection Drug Users at a New York City Medical Center

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S211-S211
Author(s):  
Sherif Shoucri ◽  
Angela Gomez-Simmonds ◽  
Amir Lankarani ◽  
Qiuhu Shi ◽  
Franklin D Lowy ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
New York City ◽  
York City ◽  
Injection Drug Users ◽  
Drug Users ◽  
Medical Center ◽  
Injection Drug ◽  
History Of ◽  
Sequence Types

Abstract Background The opioid epidemic has resulted in a dramatic resurgence of bacterial infections, most notably those due to Staphylococcus aureus (SA). We compared the demographic, clinical, and molecular factors of injection drug users (IDUs) and non-IDUs with SA bacteremia. Methods Patients with SA bacteremia were identified through a query of the electronic medical record EMR from January 2018 to December 2019 at a New York City medical center. All cases of community-associated (CA) SA bacteremia among adults with a history of active injection drug use were evaluated. Patients with positive SA blood cultures ≤ 72 hours of admission were considered CA. IDUs were identified with keyword searches and were deemed active if they had a history of use in the 12 months prior to admission. A randomly selected group of non-IDUs with CA SA bacteremia was used for comparison at a 4:1 ratio. Available SA isolates underwent Illumina whole genome sequencing (WGS). Using SRST2 multilocus sequence types (MLST), antimicrobial resistance genes and putative virulence factors were extracted. Results From January 2018 to December 2019, 669 patients with SA bacteremia were identified. 29 patients were active IDUs. Compared to 112 randomly selected non-IDUs, IDUs were significantly younger and more likely to be unstably housed (Table 1). Rates of MRSA were similar in IDUs (31%) and non-IDUs (32.1%). Endocarditis (44.8% vs 11.6%) and abscesses (27.6% vs 8.9%) were diagnosed more frequently in IDUs than non-IDUs. A positive hepatitis C antibody was strongly associated with SA bacteremia in IDUs (62.1% vs 6.3%, p< 0.001). WGS demonstrated comparable proportions of sequence types across IDUs and non-IDUs. ST8 accounted for the majority of infections in both groups (Table 2). MRSA bacteremia due to ST8 occurred in a higher proportion of IDUs (7/29, 24.1%) than non-IDUs (14/112, 12.5%). Conclusion IDUs with CA SA bacteremia have unique demographic and clinical features that differentiate them from non-IDUs. Endocarditis rates in IDUs are of particular concern. Use of these risk factors could allow hospitals to rapidly identify IDUs and offer them necessary medical and social services. WGS revealed a majority of MRSA bacteremia was due to one sequence type in IDUs (ST8). Further analysis of virulence genes in this cohort are ongoing. Disclosures Franklin D. Lowy, MD, GlaxoSmithKline (Advisor or Review Panel member)UpToDate (Other Financial or Material Support, Topic Writer and Editor) Anne-Catrin Uhlemann, MD, PhD, Merck (Grant/Research Support)

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