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OBJECTIVES To report our experience with all patients diagnosed with type 1 laryngeal cleft over a period of 3 years in our referral practice and to describe a functional diagnostic and management algorithm for children with this disorder. METHODS A prospective longitudinal study in a tertiary care referral center. Twenty pediatric patients diagnosed with(More)
OBJECTIVE To evaluate compliance with recommendations for sweat testing/specialty evaluation and genetic counseling after a positive cystic fibrosis newborn screening (CF NBS) result. STUDY DESIGN All infants with positive CF NBS results require a diagnostic sweat test at a CF center. Results that were "screen positive and diagnosis negative" prompted(More)
BACKGROUND Gastroesophageal reflux (GER) has been implicated as a causal factor in respiratory disease but prior studies have focused on the role of acid alone in the genesis of symptoms. Prior studies have relied on pH probe testing but this is blind to non-acid reflux which has been implicated in the genesis of extraesophageal symptoms. The objective of(More)
OBJECTIVES Newborn screening for cystic fibrosis (CF) provides a model to investigate the implications of applying multiple-mutation DNA testing in screening for any disorder in a pediatric population-based setting, where detection of affected infants is desired and identification of unaffected carriers is not. Widely applied 2-tiered CF newborn screening(More)
OBJECTIVES The Internet permits unprecedented and mostly unrestricted access to medical knowledge; however, concerns exist regarding viewer privacy, accountability of authorship, accuracy of information, and patient safety. To address these issues, the American Medical Association (AMA) has developed guidelines concerning web site content and visitor(More)
BACKGROUND Research is limited on physicians' compliance with recent clinical guidelines for asthma treatment. OBJECTIVE Our purpose was to investigate the relationships among clinical guidelines, asthma pharmacotherapy, and office-based visits through use of nationally representative data. METHODS Nationally representative data on prescribing patterns(More)
The ratio of controller-to-reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan-level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications(More)
OBJECTIVE To identify necessary components of a successful cystic fibrosis (CF) newborn screening (NBS) program. STUDY DESIGN The approach to CF NBS used by the Massachusetts NBS program was examined. RESULTS Several key components were identified that should be addressed when a state has made the decision to screen, and well in advance of actual(More)
From the Pediatric Pulmonary Unit (K.E.H.) and the Departments of Pediatric Surgery (D.P.R.), Radiology (R.S.), and Pathology (E.J.M.), Massachusetts General Hospital; Pediatric Otolaryngology, Massachusetts Eye and Ear Infirmary (C.J.H.); and the Departments of Pediatrics (K.E.H.), Otology and Laryngology (C.J.H.), Surgery (D.P.R.), Radiology (R.S.), and(More)
OBJECTIVES/HYPOTHESIS The utility of the lipid-laden macrophage index (LLMI) in the evaluation of airway inflammatory processes remains controversial. There is a paucity of normative data in both pediatric and adult populations, and there is wide variability in the reported cases. The goal of this project was to review the LLMI levels in a large series of(More)