Pediatrics
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Comparative Study Clinical Trial
Excessive infant crying: a controlled study of mothers helping mothers.
To determine the efficacy of behavioral management counseling in the treatment of persistent, excessive infant crying (> 3 hours per day). ⋯ Behavioral management was more effective in reducing fussing/crying than spending time with the mother talking through the problem or just waiting for spontaneous remission. Treatment by suitably but briefly trained lay counselors is an inexpensive and successful treatment option.
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Comparative Study
A program to limit donor exposures to neonates undergoing extracorporeal membrane oxygenation.
Extracorporeal membrane oxygenation (ECMO) has dramatically improved the survival of neonates with life-threatening respiratory and cardiac failure. However, ECMO requires numerous transfusions with significant risks. This study evaluated the effects of changing transfusion practices and blood component management on blood donor exposures in neonatal ECMO. ⋯ We conclude that the changes in blood bank component selection and management as well as physician practice were effective in substantially reducing ECMO-related transfusion volumes and the resulting donor exposures.
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To determine the roles of primary care physicians and specialists in the medical care of children with serious heart disease. ⋯ Primary care physicians do not take an active role in managing either the condition-specific or the more general aspects of this serious chronic childhood illness. With appropriate information and support from their specialist colleagues primary care physicians could provide much of the care for this group of children. Generalists and specialists are both responsible for educating and influencing parents about the role primary care physicians can play in caring for children with serious chronic illness.