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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)
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)
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)
Protection of human participants is a fundamental facet of biomedical research. We report the activities of a health service research study in which there were three institutional review boards (IRBs), three legal departments and one research administration department providing recommendations and mandating changes in the study methods. Complying with IRB(More)
PURPOSE To describe the strategies used by family practice program directors to recruit and select residents. METHOD The residency directors of all 361 U.S. accredited nonmilitary family practice programs in 1992-93 were asked to complete three-page questionnaires regarding program descriptors, curriculum, benefits offered, interview process, and factors(More)