Flaws in Study of Management of Children with Febrile Illness

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 866-867
Author(s):  
JOURNAL CLUB
Keyword(s):  
General Practitioner ◽  
General Hospital ◽  
General Practitioners ◽  
Family Physician ◽  
Journal Club ◽  
Febrile Illness ◽  
Emergency Rooms ◽  
Children's Hospital ◽  
Children’S Hospital

To the Editor.— Our residency's journal club recently reviewed your October issue and the article on management of febrile illness.1 We found it to be misleading and inconclusive for the following reasons. First, the study presented itself as a comparison of the management of fever in children by pediatricians and "general practitioners." Based on introductory statements the term "general practitioner" implies family physician, but this is not clearly stated. As the article progresses, we find the data collected are based on experience in emergency rooms at a children's hospital v a "general" hospital, each staffed by residents or interns.

Pediatricians and General Practitioners: A Comparison of the Management of Children with Febrile Illness

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 511-515 ◽  
Author(s):  
D. G. Leduc ◽  
I. B. Pless
Keyword(s):  
Emergency Room ◽  
General Hospital ◽  
General Practitioners ◽  
Emergency Room Visit ◽  
Febrile Illness ◽  
Acute Illness ◽  
Illness Episode ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
A Prospective Study

To assess the relative competence of pediatricians and general practitioners in managing febrile illnesses in childhood, a prospective study was undertaken of 259 children less than 10 years of age seen consecutively at the emergency room of a children's hospital and a general hospital. Both groups of patients were similar in demographic characteristics, age, sex, presenting complaints, and height and duration of fever. Of the 148 patients entered in the study at children's hospital and the 111 at general hospital, 90% and 94%, respectively, were interviewed by telephone within two weeks of their emergency room visit to determine outcomes based on duration of the acute illness episode and further physician contacts or admissions to hospital. Although no significant differences in the measured outcomes of febrile illnesses seen by pediatricians or general practitioners were found, a trend in favor of those cared for by pediatricians was discernible with respect to two key measures: unresolved symptoms at one week (8.3% vs 12.5%) and subsequent hospitalization (0.8% vs 3.0%). The overall frequency of laboratory use and antibiotic prescriptions was the same in both groups; however, significant differences were noted in the type of laboratory test used: general practitioners ordered three times more roentgenograms than pediatricians and one fifth the number of microbiologic tests. Larger prospective studies are needed to test how these findings may be generalized in view of their importance for quality assurance in the primary care of children.

Letters to the Editor

PEDIATRICS ◽  
1968 ◽  
Vol 42 (1) ◽  
pp. 210-211
Author(s):  
Gerhard Nellhaus
Keyword(s):  
General Hospital ◽  
Head Circumference ◽  
Additional Data ◽  
Massachusetts General Hospital ◽  
Letters To The Editor ◽  
Normal Intelligence ◽  
Children's Hospital ◽  
Children’S Hospital

The finding of Drs. Cloutier and Stickler that 3 of 15 children (20%) with idiopathic hypopituitarism and normal intelligence had head circumference measurements of less than -2 S.D. was most interesting. Since my own experience with hypopituitary dwarfs was limited, additional data was obtained from Dr. Thomas Aceto, Jr., of the Children's Hospital of Buffalo, Sew York, and Dr. John D. Crawford of the Children's Service of the Massachusetts General Hospital, Boston, Massachusetts.

NEWS AND ANNOUNCEMENTS

PEDIATRICS ◽  
1959 ◽  
Vol 23 (3) ◽  
pp. 618-619
Keyword(s):  
General Practitioners ◽  
Pediatric Oncology ◽  
Malignant Diseases ◽  
Pediatric Department ◽  
Memorial Fund ◽  
Children's Hospital ◽  
The Family ◽  
Children’S Hospital ◽  
Set Up ◽  
Cancer In Children

A grant of $100,000 to further treatment and investigation of cancer in children has been given to the Children's Hospital of Philadelphia by the Eugene Kardon Memorial Fund. The 4-year grant will make it possible for the Children's Hospital to expand its already comprehensive program for the care of children with malignant diseases. The fund has been set up by the family of the late Eugene B. Kardon of Merion, who was president of United Container Company. Postgraduate Course The Pediatric Department of Memorial Center for Cancer and Allied Diseases announces that the annual comprehensive 3-day course in Pediatric Oncology for pediatricians, general practitioners, and health officers will be held April 29, 30, and May 1, 1959.

Epidemic of Polypharmacy and Suggestions to Control It

1988 ◽  
Vol 9 (7) ◽  
pp. 207-208
Author(s):  
Gunnar B. Stickler
Keyword(s):  
Drug Therapy ◽  
Family Physician ◽  
Private Practice ◽  
Surgical Patients ◽  
Ambulatory Setting ◽  
Medical Patients ◽  
Children's Hospital ◽  
Pediatric Hospitals ◽  
Children’S Hospital

The term "polypharmacy" is used to describe the excessive use of drug therapy. In 1980, I reviewed the evidence of a continuing epidemic of polypharmacy.1 In 1975, there were 1.7 billion visits per year to physicians in private practice.2 Such visits to a family physician resulted in the prescription of medications to 73% of the patient contacts; in 63% of the patient visits, medications were suggested by a pediatrician. Do two thirds of our patients require medication when seen in an ambulatory setting? Pediatric hospitals did not fare much better. Of 993 patients admitted to a children's hospital, 36.7% received antibiotics.3 Using strict criteria, these authors concluded that 38% of medical patients received antibiotics inappropriately and 78% of the surgical patients did not require antibiotics.

Reye's Syndrome—Study

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 388-388
Author(s):  
Jerome S. Haller
Keyword(s):  
General Hospital ◽  
Yale University ◽  
Reye's Syndrome ◽  
Children's Hospital ◽  
Centre Hospitalier ◽  
School Of Medicine ◽  
Centre Hospitalier Universitaire ◽  
Emory University ◽  
Children’S Hospital

Because of the variety of therapies employed in Reye's syndrome, Dr. Peter Huttenlocher of Yale University School of Medicine and I have drawn up a protocol designed to evaluate the effectiveness of frequently used regimens. The study has been devised on a multi-hospital basis with the following hospitals already participating: Harbor General Hospital (Dr. Marvin Weil); Children's Hospital of Buffalo (Dr. M. Cohen); Emory University School of Medicine (Dr. J. Schwartz); Children's Hospital of Michigan (Dr. J. Finnegan); and Centre Hospitalier Universitaire, Université de Sherbrooke, Sherbrooke, Quebec (Dr. B. Lemieux).

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