Scribd Logo
Upload

Welcome to Scribd!

  • 39 views

    Literature Review: Parental Refusal of Childhood Vaccinations Tonsillectomy

    Uploaded by

    illdoit
    Adenoidectomy is second only to myringotomy as a common surgery for children. Children with nonmedical exemptions were 35 times more likely to contract measles. Parents of exempt children were more likely to report their child's primary care provider.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Literature Review: Parental Refusal of Childhood Vaccinations Tonsillectomy

    Uploaded by

    illdoit
    39 views2 pages
    Adenoidectomy is second only to myringotomy as a common surgery for children. Children with nonmedical exemptions were 35 times more likely to contract measles. Parents of exempt children were more likely to report their child's primary care provider.

    Original Title

    PDF

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Adenoidectomy is second only to myringotomy as a common surgery for children. Children with nonmedical exemptions were 35 times more likely to contract measles. Parents of exempt children were more likely to report their child's primary care provider.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    39 views2 pages

    Literature Review: Parental Refusal of Childhood Vaccinations Tonsillectomy

    Uploaded by

    illdoit
    Adenoidectomy is second only to myringotomy as a common surgery for children. Children with nonmedical exemptions were 35 times more likely to contract measles. Parents of exempt children were more likely to report their child's primary care provider.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Literature Review

    Nancy Risser, MN, RN,C, ANP Mary Murphy, CPNP, PhD Literature Review Editors

    PEDIATRIC/ADOLESCENT CARE

    and family physicians refuse to care for unvaccinated children. Immunization programs must maintain public confidence to sustain high immunization coverage rates or vaccine-preventable diseases will continue to rise.
    Tonsillectomy
    Gigante J: Tonsillectomy and adenoidectomy. Pediatr Rev 2005;26(6):199-202.

    to provide better decision-making for the need for such procedures.

    Parental Refusal of Childhood Vaccinations


    Salmon DA, Moulton LH, Omer SB, et al: Factors associated with refusal of childhood vaccines among parents of school-aged children: A case-control study. Arch Pediatr Adolesc Med 2005;159(5):470-6.

    PREVENTIVE CARE

    All states require children entering school to receive certain vaccines, but many states permit medical, religious, personal, and philosophical exemptions. Using a case-control study, the authors surveyed parents of 815 children who were exempt from one or more vaccines for school entry. The children were from private and public elementary schools in Colorado, Massachusetts, Missouri, and Washington. Most children with nonmedical exemptions received at least some vaccines. Varicella was the most common vaccine excluded. Children with nonmedical exemptions were 35 times more likely to contract measles and 5.9 times more likely to contract pertussis. Parents of exempt children were more likely to report their childs primary care provider to be a nurse practitioner or complementary alternative medicine professional, but then some pediatricians

    Tonsillectomy and adenoidectomy are no longer thought of as routine childhood procedures, but they remain second only to myringotomy as a common surgery for children. This article reviews anatomy, clinical presentation, indications, and complications for both procedures. Tonsillectomy and/or adenoidectomy can be recommended for malignancy, obstruction, or infection. Throat infections and obstructive sleep apnea syndrome are the most common indications, and depending on the study, these procedures are recommended after 3 to 7 episodes of infections over a varying period of time (1 to 3 years). While complications are rare, they include anesthetic complications and bleeding, which can occur within 24 hours to as late as 2 weeks postoperatively. Velopharyngeal insufficiency can occur and, if it is not transient, may require speech therapy and surgical repair. The benefits of tonsillectomy are marginal and randomized. Controlled clinical trials are needed

    Bowel Preparation for Colonoscopy


    Colonoscopy preparations. The Medical Letter 2005;47(1212):53-4.

    Several methods are available to cleanse the bowel before colonoscopy. Polyethylene glycol (PEG) electrolyte solutions, which pass through the bowel without absorption, are the safest choice for patients who cannot tolerate a fluid load. About 10% of patients are unable to drink the required 4 liters due to salty taste, large volume, and the resultant nausea and abdominal fullness. One approach uses 2 liters of PEG solution together with four delayed-release tablets of bisacodyl a few hours before the procedure. In another approach to improve taste, the laxative powder PEG 3350 (Miralax) has been mixed with Gatorade, but the sugars in Gatorade may be converted to flammable gases, which theoretically could ignite when electrocautery is used to remove a polyp. Sodium phosphate (Fleet Phospho-Soda) costs less than $3 compared to $18 to $49 for PEG

    Literature Review offers succinct summaries of articles published in recent clinical journals.
    The journals reviewed include: American Family Physician American Journal of Medicine Annals of Internal Medicine Archives of Pediatric and Adolescent Medicine British Journal of Medicine CA: A Cancer Journal for Clinicians Cancer Clinical Pediatrics Journal of Emergency Medicine Journal of the American Medical Association Journal of Pediatric Health Care Obstetrics and Gynecology Lancet Mayo Clinic Proceedings MCN: The American Journal of Maternal/Child Nursing The Medical Letter Morbidity and Mortality Weekly Report New England Journal of Medicine Pediatric Annals Pediatric Nursing Pediatrics Pediatrics in Review

    66 The Nurse Practitioner Vol. 30, No. 10

    www.tnpj.com

    Literature Review
    solutions, but it can result in bowel lesions that mimic inflammatory bowel disease and a decrease in intravascular volume that leads to dizziness, fainting, falls, or seizures. Sodium phosphate is contraindicated in patients with congestive heart failure, gastric obstruction, renal failure, or ascites; it should be used with caution in the elderly. According to Medical Letter consultants, the best mix of efficacy, tolerability, and safety in cleansing the bowel for colonoscopy is the combination of 2 liters of a PEG solution plus 4 delayed-release bisacodyl tablets.
    Does Vitamin E or Donepezil Prevent Dementia?
    Petersen RC, Thomas RG, Grundman M, et al: Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 2005;352;2(3):2379-88. Blacker D: Mild cognitive impairment-no benefit from vitamin E, little from donepezil. N Engl J Med 2005;352;2:(3):2439-41(editorial).

    In a double-blind study, 769 subjects with the amnesic subtype of mild cognitive impairment were randomly assigned to receive vitamin E 2,000 units daily, donepezil (Aricept) 10 mg daily , or placebo for 3 years. Possible or probable Alzheimers disease developed in 212 subjects with no significant differences in the probability of progression to Alzheimers disease in the vitamin E group (hazard ratio = 1.02) or the donepezil group (HR = 0.80). Compared with the placebo group, the donepezil group progressed more slowly to Alzheimers disease at first (p = 0.04 during the first 12 months). In those study subjects with apolipoprotein E e4 alleles, the benefit of donepezil was significant at each analysis throughout the 3-year follow-up. Vitamin E had no benefit at any point, either among all patients or among the apolipoprotein E e4 carriers.

    were mailed questionnaires about symptoms and management strategies. The 8,405 women averaged 69 years of age when they stopped the study pills, which they had been taking for an average of 5.7 years. Moderate-to-severe vasomotor symptoms were reported by 21% of hormone users and 4.8% of placebo group respondents (Adjusted Odds Ratio [AOR] 5.82, 95% CI 4.92 to 6.89). Compared with respondents in the placebo group, pain or stiffness symptoms were also more likely in respondents in the estrogen/medroxyprogesterone group (AOR 2.16; 95% CI 2.90 to 3.56). Both vasomotor symptoms (AOR 5.36) and pain or stiffness symptoms (AOR 3.21) were more common in women who reported these symptoms at baseline. Among women who never had vasomotor symptoms, stopping hormone therapy did not appear to induce the symptoms. The study may not be representative of all women who stop hormone therapy since 40% of original Womens Health Initiative participants had stopped study pills before the end of the study. The high frequency of symptoms reported may be a result of abrupt withdrawal from hormone therapy. When hormone therapy is to be stopped, gradual tapering of the dose is suggested.

    WOMENS HEALTH CARE

    Menopausal Hormone Therapy


    Ockene JK, Barad DH, Cochrane BB, et al: Symptom experience after discontinuing use of estrogen plus progestin. JAMA 2005;294(2):183-93. Petitti DB: Some surprises, some answers, and more questions about hormone therapy: further findings from the Womens Health Initiative. JAMA 2005;294(2):245-5 (editorial).

    Eight to 12 months after stopping menopausal hormone therapy, women in the Womens Health Initiative study
    www.tnpj.com
    The Nurse Practitioner October 2005 67

    You might also like