George E Kikano

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Difficulty swallowing or dysphagia can be present in children and adults alike. Pediatric dysphagias have long been recognized in the literature. Certain groups of infants with specific developmental and/or medical conditions have been identified as being at high risk for developing dysphagia. Still others may present with a swallowing or feeding problem as(More)
Lead poisoning is a common disease that, if not detected, can lead to developmental delay and other serious sequelae. We report the case of a child with retained intracranial lead pellets from a gunshot injury, in whom elevated blood lead levels were detected approximately 1 year after the injury. No environmental source of lead was found, and a twin sister(More)
BACKGROUND Many physicians today are employed by another physician, group, hospital, HMO, or other organization. However, the differences in the characteristics, practice patterns, and patient outcomes of self-employed and employed physicians are not well understood. METHODS The practices of 108 community family physicians in northeast Ohio were assessed(More)
OBJECTIVE To compare the concordance of family physicians' billing for evaluation and management services with medical record documentation. DESIGN Multi-method, cross-sectional observation study. SETTING Eighty-four family practices in northeast Ohio. PARTICIPANTS Four thousand fifty-four outpatients visiting 138 family physicians. MAIN OUTCOME(More)
BACKGROUND Little is known about the accuracy of family physicians' use of the Current procedural Terminology (CPT) coding scheme for office visits, despite increased administrative oversight of Medicare billing practices. In addition, the patient and visit characteristics that are associated with over- and undercoding are not well understood. METHODS(More)
Recent studies show that acute and chronic hyperglycemia cause a diffuse decrease in regional cerebral blood flow and that chronic hyperglycemia decreases the brain L-glucose space. Since these changes can be caused by a decreased density of perfused brain capillaries, we used 30 adult male Wistar rats to study the effect of acute and chronic hyperglycemia(More)
Speech dysfluency (stuttering) is common in children. Although stuttering often resolves before adulthood, it can cause significant anxiety for children and their families. Stuttering speech patterns are often easily identifiable; when a child is learning to talk, repetition of sounds or words, prolonged pauses, or excessively long sounds in words usually(More)
BACKGROUND Although physical activity is important for the prevention and management of a variety of common chronic diseases, the prevalence and patient and visit characteristics associated with provision of physical activity advice by community family physicians is not well understood. METHODS In a cross-sectional multi-method study of 138 family(More)
Atherothrombosis is a progressive and generalized pathologic process that affects the vascular system. Clinical manifestations of atherothrombosis depend on the affected vascular bed and include acute coronary syndromes, stroke, and peripheral arterial disease. Ischemia associated with atherothrombosis is highly prevalent, affecting millions of people each(More)