Stephen M Borowitz

INTRODUCTION: Environmental enteric dysfunction (EED) is a subacute inflammatory condition of the small intestinal mucosa with unclear aetiology that may account for more than 40% of all cases of stunting. Currently, there are no universally accepted protocols for the diagnosis, treatment and ultimately prevention of EED. The Bangladesh Environmental Enteric Dysfunction (BEED) study is designed to validate non-invasive biomarkers of EED with small intestinal biopsy, better understand ...

BACKGROUND: Childhood constipation is a common problem, accounting for 3% of visits to pediatric clinics and 30% of visits to pediatric gastroenterologists. Estimates of the prevalence of childhood constipation vary from 0.3% to 28% with younger children being affected most often. We were unable to find any studies that specifically examine the causes of constipation in young children. Our objective of the study was to determine precipitants to constipation during early ...

BACKGROUND: Inflammatory bowel disease (IBD) is characterized by periods of relapse and remission. Treatment is aimed at reducing symptoms during relapse and prolonging the duration of remissions. 6-Mercaptopurine (6-MP) and its prodrug azathioprine (AZA) are commonly used to prolong clinical remissions. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are two widely used laboratory markers of inflammation. The authors observed an unexplained discordance between ESR ...

OBJECTIVE: Childhood constipation accounts for 3% of visits to general pediatric clinics and as many as 30% of visits to pediatric gastroenterologists. The majority of children who experience constipation and whose caregivers seek medical care are seen by primary care physicians such as pediatricians or family physicians. Little is known about how primary care physicians treat childhood constipation or the success of their treatments. With this study, we prospectively examined which ...

OBJECTIVE: To determine whether information collected during the National Resident Matching Program (NRMP) predicts clinical performance during residency.

METHODS: Ten faculty members rated the overall quality of 69 pediatric house officers as clinicians. After rating by the faculty, folders were reviewed for absolute rank on the NRMP match list; relative ranking (where they ranked in their postgraduate year 1 [PGY-1] group); scores on part I of the National Board of Medical Examiners ...

Chronic constipation is an extremely common problem in children. Many authors have advocated using anorectal manometric examination during evaluation of chronic childhood constipation and encopresis as a means of developing individualized modes of treatment.

PURPOSE: This study was designed to prospectively examine frequency and severity of symptoms of childhood constipation and encopresis and associate these symptoms with anorectal manometric findings.

METHODS: Forty-four children with ...

BACKGROUND: During sign-out (handover of care), information and responsibility about patients is transferred from one set of caregivers to another. Few residency training programmes formally teach resident physicians how to sign out or assess their ability to sign out, and little research has examined the sign-out process.

OBJECTIVE: To characterise the effectiveness of the sign-out process between resident physicians on an acute care ward. Design/

METHODS: Resident physicians rotating ...

INTRODUCTION: An information prescription is the provision of specific information to a patient on how to help manage a health problem. The Internet is being used increasingly as a source for information prescriptions, with clinicians directing patients to specific Web sites. As with any health care intervention, patients' lack of compliance is a barrier to the effectiveness of Web-based information prescriptions (WebIPs). WebIPs cannot be helpful if patients do not review the ...

BACKGROUND: The Internet is a significant source of medical information and is now being shown to be an important conduit for delivering various health-related interventions.

OBJECTIVE: This paper aimed to examine the utility and impact of an Internet intervention for childhood encopresis as part of standard medical care in a "real world" setting.

METHODS: Patients diagnosed with encopresis were given a Web-based information prescription to use an Internet intervention for pediatric ...

CONTEXT: Despite the common use of e-mail, little beyond anecdote or impressions has been published on patient-clinician e-mail consultation.

OBJECTIVE: To report our experiences with free-of-charge e-mail consultations.

DESIGN: Retrospective review of all e-mail consultation requests received between November 1, 1995, and June 31, 1998.

SETTING AND PARTICIPANTS: Consecutive e-mail consultation requests sent to the Division of Pediatric Gastroenterology at the Children's Medical Center ...

BACKGROUND: There are significant gaps in understanding what sources of patient information physicians utilize in the Neonatal Intensive Care Unit (NICU).

OBJECTIVE: We conducted a qualitative study of physicians' self-report of information-seeking behaviors in the NICU of an academic medical center.

METHODS: The study used a survey design to assess resident and faculty physicians' perceptions of their utilization of written and verbal sources of patient information. Faculty and resident ...

OBJECTIVE: To validate a theoretical model of encopresis in terms of psychological factors that differentiates children with and without chronic encopresis and to identify scales that demonstrate these differences.

METHODS: Eighty-six children with encopresis were compared to 62 nonsymptomatic children on five psychometric instruments. Differences in the mean scores and the percentages of children falling beyond preselected clinical thresholds were compared across the patient-control ...

In this article we describe the clinical history, diagnostic evaluation, and management of an infant who had congenital glucose-galactose malabsorption (CGGM)--a rare disorder thought to be inherited as an autosomal recessive trait. Because of defective sodium-coupled cotransport of glucose and galactose in the intestinal mucosa, infants with CGGM suffer from chronic, profuse, watery diarrhea that often leads to hypertonic dehydration. This infant experienced persistent diarrhea and ...

Since 1995, we have maintained a tutorial about chronic childhood constipation and encopresis on our web site. The tutorial is directed at parents and older children and includes a feedback form comprised of six multiple-choice questions and a free-text comment field. Between 1 January 1998 and 30 April 2000, we received 1,142 completed feedback forms. The vast majority of respondents identified themselves as parents or guardians of a child with constipation or encopresis. All ...