Rosalie F. Tassone

Attitudes, Patterns of Recommendation, and Communication of Pediatric Providers About Complementary and Alternative Medicine in a Large Metropolitan Children’s Hospital

The authors conducted an Email survey of their medical staff to explore the attitudes, patterns of recommendation, and communication of pediatric providers about complementary and alternative medicine (CAM) in a large metropolitan children’s hospital. Two thirds of the respondents reported awareness about their patients’ CAM therapy use (65%) and recommended CAM therapy to their patients (67%). Providers who reported personal use of CAM (71%) were more likely to recommend CAM to their patients compared with those who do not (76% vs 45%; P < .05). One half of pediatric providers reported occasional consultation with their patient’s CAM provider, but bidirectional communication was rare (4%). Specific changes in care based on a CAM provider’s recommendations were also unusual (4%). Despite the positive attitudes about and willingness to recommend CAM by pediatric providers, communication between these clinicians and CAM providers may be less than ideal.

Foot Yang Ming Stomach Meridian 足陽明胃經穴

ST 1 Chengqi 承泣 On the depression in the midline of lower eyelid. ST 2 Sibai 四白 Three tsun below ST 1, in the depression at the infraorbital foramen. ST 3 Juliao 巨髎 Directly below the midline of lower eyelid at the level of lower border of the ala of nose. ST 4 Dicang 地倉 Half tsun lateral to the corner of the mouth. ST 5 Daying 大迎 Anterior to the angle of mandible, in the depression anterior to the masseter attachment. ST 6 Jiache 頰車 One-finger breadth anterior and superior to the angle of the mandible. ST 7 Xiaguan 下關 On the lateral of face, in the depression between midpoint below of the lateral zygomatic arch and mandibular notch. ST 8 Touwei 頭維 Half tsun within the ideal hairline at the corner of the forehead; 4.5 tsun lateral to the midline. ST 9 Renyins 人迎 At the anterior margin of the sternocleidomastoid muscle at the level of upper border of thyroid cartilage. ST 10 Shuitu 水突 At the anterior margin of the sternocleidomastoid muscle at the level of upper border of cricoids cartilage. ST 11 Qishe 氣舍 Above the clavicle at the depression between sterna head and clavicle head of sternocleidomastoid muscle. ST 12 Quepen 缺盆 At supraclavicle fossa 4 tsun lateral to the anterior median line of the neck.

Foot Shao Yin Kidney Meridian 足少陰腎經穴

Principal acupuncture points of the Foot Shao Yin Kidney Meridian. Foot Shao Yin Kidney Meridian acupuncture points

Acupuncture for the Treatment of Functional Disorders in Children

Increasing numbers of patients in the USA, both adults and children, are pursuing complementary and alternative therapies for health care. Acupuncture is one such therapy, which has been utilized in health care for thousands of years in China and other Asian cultures. This chapter provides a brief background about acupuncture therapy, various modalities that comprise the practice of acupuncture, and evidence related to its use with pediatric patients and functional disorders. We also present case-based scenarios to demonstrate successful use of acupuncture therapy.

Sudden Onset of Atrial Flutter During Continuous Venovenous Hemodialysis

A 56-YEAR-OLD MAN was admitted to the authors’ intensive care unit with an exacerbation of congestive heart failure concomitant with hypotension (80/49 mmHg) and hyperkalemia (6.2 mmol/L). The patient had end-stage cardiomyopathy and hemodialysis-dependent renal failure resulting from chronic human immunodeficiency virus infection. Transthoracic echocardiography revealed biventricular failure with an ejection fraction of 15%. A chest radiograph showed cardiomegaly and pulmonary edema. A 12-lead electrocardiogram (ECG) showed normal sinus rhythm and nonspecific T-wave changes in the lateral leads. Inotropic support (intravenous infusions of dobutamine and dopamine) was begun to support the patient’s arterial blood pressure, and continuous venovenous hemodialysis (CVVHD) was initiated for the treatment of hyperkalemia. Approximately 1 hour after CVVHD was begun, the intensive care unit nurse reported the presence of new-onset atrial flutter to the resident on call. A new 12-lead ECG was consistent with this diagnosis (Fig 1). Clinical symptoms were absent as a result of the arrhythmia, and the physical signs, including heart rate (86 beats/min) and arterial blood pressure (100/65 mmHg), essentially were unchanged. In response to this apparent medication-related atrial flutter, the intravenous infusion of dobutamine was discontinued and the infusion rate of dopamine was reduced. CVVHD of intravascular