bluuebunny/crossref_metadata_2025 huggingface dataset:
Benign Chronic Diarrhea of Infancy
Authors: Walker W. Allan
Published: December 2021

Chronic nonspecific diarrhea of infancy (CNSD) or irritable bowel syndrome represents one of the most common gastrointestinal problems confronted by practicing pediatricias. In the subspecialty setting of the pediatric gastroenterologist, this entity comprised almost 35% of the outpatient referral practice. CNSD, originally thought to be part of the celiac syndrome, was described as a separate clinical entity by Cohlan in 1956.1 Since that time in the classic paper on this subject, Davidson and Wasserman2 have described consistent diagnostic criteria further characterizing CNSD as a recognizable syndrome. The onset of symptoms occurs classically between 6 and 30 months of age with the development of three to six loose stools with mucous per day, with no associated malabsorption or growth and development abnormalities (to be discussed in detail below). Whereas spontaneous resolution of CNSD is anticipated by 39 months of age, longitudinal observations indicate that these patients have a high incidence of functional bowel complaints during adolescence and beyond suggesting a continuum with "irritable bowel syndrome" of adulthood.3 From the standpoint of the child, this "complaint" all too frequently becomes the "problem" when the frequency and/or consistency of the bowel movements impair training or become intolerable to the parents.
Syndromes and Eponyms
Authors: V. V. C.
Published: December 2021

A reader has recently questioned dropping the possessive when referring to conditions described by individuals, that is, Down syndrome vs Down's syndrome. He notes that this practice has made him uncomfortable. Since my mentor regarding this matter was Dr Vaughan, I referred the question on to him and his informative comment follows.

"This raises a point of style about which many physicians have strong feelings, which are rooted in the comfort we have in ways in which we first, as medical students, learned about syndromes and eponyms. Medicine has always been inconsistent in this style: we never gave two people possession of a syndrome (Niemann-Pick disease, Smith-Lemli-Opitz syndrome); nor have we always given possessive credit to other innovations (McBurney incision, Trendelenburg position, Charcot joint); nor, in fact, do all syndromes or conditions belong to the person who first described them—some belong to the patient (Christmas disease, Hartnup syndrome).

In light of these inconsistences, the style manual of the American Medical Association (Stylebook) in its 1976 revision (6th edition) recommended (page 26) that eponyms no longer be given the possive form. It takes an emotional wrench to make the change, and a little time to get used to it (Wilms tumor, Hodgkin disease), but after a while it flows remarkably easily and comfortably, conserves apostrophes, esses, paper, and space, and often comes to seem eminently reasonable (Vaughan contention). I would be pleased to see the style adopted universally.(V.C.V.
Pelvic Examination of the Adolescent Patient
Authors: Emans S. Jean
Published: December 2021

Providing health care to adolescent girls in the 1980s involves knowledge of many topics. A thorough understanding of the gynecologic problems that may occur during adolescence as well as comfort with the normal pelvic examination allows the pediatrician to provide this aspect of primary care. Not only does the physician need the technical skills which include speculum examination of the vagina and bimanual rectovaginal-abdominal palpation, but the practitioner seeing adolescents also needs the interpersonal skills, sensitivity, and time to establish a primary relationship with the adolescent herself. Principles of caring for adolescents and their families are not discussed here but are of obvious importance in dealing with a pelvic examination.

Pamphlets on a variety of gynecologic and nongynecologic subjects should be readily available in the office. Education for the young teenager should discuss leukorrhea, normal development, menses and menstrual cramps, and the use of tampons. The intermittent use of conventional tampons changed frequently allows the adolescent girl more freedom in activities and athletics, makes her more comfortable with her body, and makes the routine pelvic examination simpler and less anxiety provoking. The use of tampons is especially helpful in preparing the young adloescent exposed in utero to diethylstilbestrol for speculum examination. The adolescent should be encouraged to discuss boyfriends and peer relations.
Counseling Parents of a Child with Meningomyelocele
Authors: Leonard Claire O.
Published: December 2021

The primary care physician has an important role in counseling families of children with meningomyelocele and providing ongoing support and coordination of care. A spina bifida treatment center will provide subspecialists in neurology, neurosurgery, orthopedics, urology, physical therapy, occupational therapy, nutrition, social work, and genetics. When the family does not live near a center, the pediatrician may fill many of these roles as well as that of team coordinator himself with the psychosocial and educational issues, as these are often forgotten by the multiple subspecialists seen by these children. The outlook for children with spina bifida is changing rapidly. The evolving medical, educational, and social treatment of individuals with meningronyelocele makes reliable prognostic information unavailable. Intelligence is usually normal and death due to renal insufficiency is extremely rare. A follow-up of surviving patients treated from 1928 to 1951 revealed that more than half were self-sufficient, full-time college students or housewives.7 With the improved outlook today, the majority of affected children can expect to become independent adults.
Visual System Screening in Infants and Young Children
Authors: Gammon J. Allen
Published: December 2021

Many abnormalities of the visual system in infants and young children respond to treatment when instituted at an early age. Ocular abnormalities that require early recognition and therapy include congenital cataracts, congenital glaucoma, intraocular tumors, intraocular inflammation, large errors of refraction, strabismus, and corneal opacities (Figs 1 to 6). The visual prognosis for children with these problems is often directly related to early detection and treatment of the visual disorder.

Visual deprivation of young laboratory animals can permanently damage their developing central nervous system. Diseases once believed hopeless, such as monocular congenital cataracts, can now be treated.1 Technologic advances, such as extended-wear contact lenses which are useful for infants who have had cataract surgery during the first few weeks of life, have facilitated visual rehabilitation of young eyes.

Corneal opacities, complete ptosis, prolonged patching, and eyelid or orbit abnormalities such as large hemangiomas can cause amblyopia if the vision is obstructed. Even brief occlusion can result in irreversible amblyopia during the early months of life.2 Unilateral disruptions of vision are generally more damaging to the eye than are bilateral ocular abnormalities. Each of the young child's eyes must enjoy a clear, focused retinal image for visual development to progress normally.

Early diagnosis and treatment of congenital glaucoma is important so that intraocular pressure can be lowered, thereby, avoiding irreversible anatomic damage to the eye.
Patient Education in Asthma Management
Authors: ANDERSON JOHN A.
Published: December 2021

Three times each publication year, Ross Laboratories assists one of our authors in the preparation of adjunctive educational material, for distribution to pediatricians. These have ranged from the audiotape of normal heart murmurs, prepared by Dr Liebman, to patient and parent education posters, suitable for the office, relating to problems of the developing foot and the use of appropriate shoes. Several educational objectives this year, as in all previous years, deal with the appropriate diagnosis and management of children with asthma—the most common chronic physical disease of childhood. Dr John Anderson has prepared a patient and parent education booklet, which will be distributed to pediatricians by Ross Laboratories following the publication of this issue of PEDIATRICS IN REVIEW.
Therapy of Petit Mal (Absence) Seizures
Authors: Holmes Gregory L.
Published: December 2021

Although petit mal or typical absence seizures are not life threatening, it is important for the pediatrician to recognize the disorder because untreated they can affect school performance, increase the risk of accidental injury, and lead to the victim's being ridiculed by classmates for being "spacey."

CLASSIFICATION

Unfortunately, petit mal is probably the most misused term in epileptology. In 1969, The International League Against Epilepsy published a classification of epileptic seizures entitled The International Classification of Epilepsy. This classification, which has recently undergone revision, categorizes seizures into two groups: partial, seizures in which the first clinical and electroencephalographic changes indicate initial activation of a system of neurons limited to a part of one cerebral hemisphere, and generalized, those in which the first clinical changes indicate initial involvement of both hemispheres. In absence seizures, as in all primary generalized seizures, the ictal EEG patterns are bilateral and reflect neuronal discharge which is widespread. Absence seizures can be further subdivided into typical and atypical absences (Table 1).

Although the term petit mal has been eliminated from the revised International Classification of Seizures, the term is still widely used by physicians. Most physicians use it to describe a simple absence with impairment of consciousness only, and with a rhythmic, three cycles per second, spike and wave discharge on the electroencephalogram in a child between age 3 years and puberty who has normal intelligence and in whom a neurologic examination prduces normal findings.
Lactic Acidosis in Children—Pathophysiology, Diagnosis, and Treatment: A Workbook Exercise
Authors: Yudkoff Marc , Burg Fred
Published: December 2021

This article is designed to give you an opportunity to learn how lactic acidosis affects children, and how to diagnose and treat a child with this disorder. The process we have utilized is an interactive one in which you will be presented with questions commingled with problems and discussion.

CASE REPORT

A 3-month-old male infant had been well until two days prior to admission, when he had developed fever, vomiting, and diarrhea. Initially the vomiting and diarrhea were mild, and a pediatrician recommended administration of clear liquids. On the day of admission the infant ate nothing at all, vomited every one to two hours, and had more than ten stools, all of which consisted primarily of water. The parents reported that by 5 PM the child became suddenly pale and his skin seemed cool, although when they took the rectal temperature it was 37.7 C(100 F). The baby became increasingly lethargic and limp. By 6 PM, when the parents rushed the child to the emergency room, he could not be awakened at all.

The receiving physician in the emergency room found an unresponsive flaccid baby with a respiratory rate of 62 breaths per minute. A feeble pulse was 154 beats per minute and the rectal temperature was 38.1 C. The odor of acetone was apprent in the baby's breath.
Hematuria in Childhood
Authors: Kaplan Matthew R.
Published: December 2021

The causes of hematuria, both gross and microscopic, in the pediatric patient are numerous and confusing. The pediatrician should develop an organized, logical sequence of diagnostic steps, the keystones of which are (1) a careful review of the history, (2) physical findings, and (3) simple, inexpensive, minimally invasive laboratory and radiologic tests. If serious pathology is suspected, early referral to a nephrologist or urologist is urged. In these instances, renal biopsy or invasive urologic evaluation is probably inevitable.
Rectal Bleeding
Authors: SMITH E. IDE
Published: December 2021

After reading "Rectal Bleeding in Childhood" by Hillemeier (PIR 5:35, 1983), I would like to raise a question concerning the child with lower rectal bleeding and a demonstrable anal fissure.

In the article, the statement is made, "Once the determination has been made that the child has rectal bleeding from the lower GI tract, an endoscopic procedure is required." I would question the necessity of endoscopy with its additional complexity and definite increased costs as a requirement in the treatment of children with anal fissures. Obviously, some clinical judgment is necessary as the presence of an anal fissure does not rule out disease above, but in many clinical situations, a diagnosis can be made and appropriate therapy can be initiated without endoscopy. An additional problem, which has occurred frequently in my experience, is that many of the children with anal fissures have considerable constipated stool present at the time of their visit and the endoscopy requires an additional visit.

In the absence of abdominal pain or any evidence of significant bleeding and in a clinical setting that is confirmatory of an anal fissure, I would suggest that a demonstrable fissure may be treated without endoscopy.
Zinc Deficiency in the Premature Infant
Authors: Hambidge K. Michael
Published: December 2021

Although zinc was recognized to be essential for the growth of microorganisms during the 19th century, and for the growth of mammals 50 years ago, interest in the role of zinc in human nutrition has developed only in the last 20 years. Hence, in contrast to iron and iodine, zinc can be regarded as one of the "newer" trace elements in this context. Human deficiencies of several of these newer trace elements are now recognized, but human zinc deficiency syndromes are of special interest to the clinician. The clinical importance of this trace element stems from the frequency of zinc deficiency states relative to those of the other newer trace elements, the wide variety of circumstances in which zinc deficiency may occur, the number of organ systems and major metabolic pathways that may be affected, and the extent of the clinical consequences. The cardinal importance of zinc for normal growth and development, both prenatally and postnatally make this micronutrient of special interest to the obstetrician and pediatrician.

This article will focus primarily on the premature infant. Despite the paucity of information, zinc nutrition is of particular concern in this nutritionally challenging population group for several reasons. First, the relatively rapid growth of the healthy premature infant, after initial stabilization, suggests the need for relatively large quantities of zinc to meet the demands of new tissue, especially lean body mass.
Some Reminders About Prescription Writing
Authors: Mofenson Howard C. , Caraccio Thomas R.
Published: December 2021

A prescription is a written order by a physician to a pharmacist to dispense a therapeutic agent to a patient. This therapeutic transaction is the sum of the physician's evaluation of the problem (the history, physical examination, diagnostic tests, decision on treatment, and prognosis). On this single sheet of paper are the final results of the physician's education, experience, and diagnostic acumen.

The prescribing physician should use a drug only if necessary and should choose the safest and most effective agent with which he has knowledge and experience. The physician should know the ingredients that make up the contents of the drug, not only the active ingredients, but inactive ingredients as well, such as the sugar content, the alcohol content, preservatives, emulsifiers, fillers, and stabilizers.

HOW TO WRITE A GOOD PRESCRIPTION

1. Write or print the prescription legibly. If the physician has poor writing, preprinted or typed prescriptions may help.

2. Spell the name(s) of the drug(s) correctly, especially in view of the number of "look-alikes" and "sound-alikes." Get in the habit of writing both the trade and generic names.

3. Write the prescription in proper English grammar. Latin abbreviations such as q.i.d. may be interpreted as q.d. and are no longer recommended. Avoid phrases such as "as directed" or "as needed." Specify exact times to be taken: daytime hours, around the clock, and relationship to meals.
Current Management of Common Bacterial Meningitides
Authors: Kaplan Sheldon L.
Published: December 2021

Bacterial meningitis is one of the most important, relatively frequent life-threatening infections encountered in children; thus physicians caring for children must be familiar with the current recommendations concerning its management. Newer antibiotics, especially third-generation cephalosporins, have provided satisfactory alternatives to the standard antibiotic treatment of bacterial meningitis in children but present the pediatrician with a baffling array of potential choices that can lead to confusion and indecision when selecting an agent to administer. At the present time, none of these newer agents has emerged as clearly superior to the others, and, therefore, a particular agent cannot be recommended as the single drug of choice for the treatment of bacterial meningitis in the pediatric age group. This review will focus on the antibiotic treatment and supportive care of the child with bacterial meningitis due to the most common pathogens

ANTIMICROBIAL THERAPY OF BACTERIAL MENINGITIS IN CHILDREN

The principles of the antibiotic therapy of bacterial meningitis have been derived from both clinical studies and animal models.1 It is clear that an antibiotic must be bactericidal in vitro against a particular microorganism in order to be most effective in vivo. Antibiotics that only inhibit growth of an organism frequently do not result in sterility of CSF in animal models or in the human host.
Prevention of Infection with Neisseria meningitidis and Haemophilus influenzae Type b
Authors: Feigin Ralph D.
Published: December 2021

MENINGOCOCCAL DISEASE

Background

Since the first description by Vieusseux in 1805 of an epidemic of "cerebrospinal fever," physicians have been aware of the potential for spread of meningococcal disease. Numerous studies of military recruits in the United States documented conclusively nasopharyngeal acquisition of Neisseria meningitidis during the course of their basic training. In the military setting, attack rates as high as 46% have been reported for exposed susceptible individuals.

In the United States, endemic meningococcal disease occurs in 3,000 to 5,000 persons yearly. Secondary cases occur with a frequency of 0.4% in the first month following disease in the index case. The risk to household contacts is approximately 2.2/1,000/yr; this risk is greatest in the week after the onset of illness in the index case but remains in excess of the endemic disease rate for at least 1 month. The risk of secondary meningococcal disease in household contacts (adults and children) of an index case is 1,000 times greater than that for the population as a whole.

Carriage Versus Invasive Disease

Household contacts, day care center contacts, and bunk mates (military installations) of an index case frequently are noted to have an increased rate of carriage of N meningitidis in the nasopharynx. It has been noted repeatedly that when the carriage rate of N meningitidis is high, invasive disease is more likely to occur.
Impetigo
Authors: Lookingbill Donald P.
Published: December 2021

In our practice, S. aureus is the most common cause of impetigo. In its usual form, staphylococcal impetigo appears as honey-colored crusts that cover a very shallow erosion. Staphylococcal bullous impetigo results in clear blisters and thin varnish-like crusts. Group A streptococci usually cause crusted ulcers surrounded by erythema. Partial removal of the crusts will reveal the depth of the process and thus help to distinguish clinically between staphylococcal and streptococcal forms. Cultures will further confirm the diagnosis. Herpes simplex is the disease most commonly misdiagnosed as impetigo. Several other skin diseases less commonly cause confusion. The treatment of first choice for all types of impetigo is a seven- to ten-day course of oral antibiotics, either erythromycin or dicloxacillin.
Variations in Normal Sexual Development
Authors: Copeland Kenneth c.
Published: December 2021

Children whose sexual development appears atypical or seems unusually early or late are best considered to have either variations occurring during the process of sexual differentiation or variations in the pattern or process of sexual maturation. Recognizing a case of overt pathology may be relatively easy compared to confidently diagnosing an atypical case as a "normal variant." The recognition of clinical clues of pathologic development, as well as a thorough understanding of typical sexual development, inevitably will aid in the development of such clinical confidence.
Magnetic Resonance Imaging
Authors: Brody Alan S. , Gooding Charles A.
Published: December 2021

Magnetic resonance imaging is the newest of the imaging modalities available for the diagnosis of diseases of children. No ionizing radiation is used and most studies are performed without the administration of contrast material.

FUNDAMENTALS OF MAGNETIC RESONANCE IMAGE FORMATION

Physics

The physics of magnetic resonance imaging is only accurately explained by complex mathematics, but analogy can serve as a rough guide. When placed in a strong magnetic field, atomic nuclei containing odd numbers of protons and neutrons align along the lines of magnetic force. The magnetic fields used are in the range of 6,000 to 15,000 G. (The earth's magnetic field measures 5 G.) Although many kinds of nuclei can be used, current magnetic resonance imaging systems image hydrogen nuclei.
Recurrent Abdominal Pain: The Cost of the Aches and the Aches of the Cost
Authors: Coleman William L. , Levine Melvin D.
Published: December 2021

Recurrent abdominal Pain is the most common chronic pain entity in the school-aged child and young adolescent.1,2 It is rarely seen before a child is 5 years of age; its peak incidence in children is 10 to 12 years of age. Although definitions vary, different studies estimate the prevalence at 10% to 15%; girls slightly outnumber boys.2,3

Recurrent abdominal pain accounts for 5% of pediatric office visits4 and continues to be a challenging, frustrating, time-consuming enterprise, one capable of generating intense anxiety on the part of children, parents, and seasoned clinicians. Multiple diagnostic tests may be painful (and fruitless). Significant costs may be incurred through diagnostic procedures, laboratory investigation, extensive medical evaluations (including subspecialty consultations), hospitalization, lost work days for parents, and caretaker's fees. Children also suffer a reduction in normal activity and sacrifice school days.3,5 Finally, there is the toll (for child and parent) of living with the symptom(s) of a "disease" without knowing its cause, cure, or prognosis.6

The object of this review is to present a multifactorial model of causation and a cost-efficient approach for the practical management of recurrent abdominal pain. Two case prototypes will portray the conceptual framework and highlight practical issues in diagnosis and management.
A Child's Reactions to Parents' Problems
Authors: Woolston Joseph L.
Published: December 2021

In the current world of high technology and glorification of "hard" science, the study of a child's reactions to his parents' problems may seem a bit archaic or sentimental. One might wonder what new information could have been learned in the past several decades about these age-old human problems for which common sense, rather than new data, might seem to serve as the best guide. However, the more rigorous applications of scientific methods of psychiatry, psychoanalysis, epidemiology, cybernetics, and psychology have shed new light on this age-old problem. Perhaps the most challenging aspect of addressing the issue of a child's reaction to his parents' problems is the bewildering diversity of possible responses. To propose that one kind of parental problem gives rise to one kind of reaction in a child obviously in nonsense. Although there seem to be some reactions that are more likely to occur in response to some specific parental problems, children can and do respond with the entire repertoire of emotional and behavioral reactions that are available to them as human beings.

The following case illustrates the complexity and diversity of a child's reactions to his parents' problems.

DG was an 8-year-old boy who was referred for a psychiatric evaluation by his pediatrician because of concerns about DG'S poor attention span, excessive activity, and provocative behaviour.
Iron Supplementation in Infancy
Authors: Reeves Jerry D.
Published: December 2021

Although dietary practices in the United States have changed in the past decade to include more bioavailable iron in many infant's diets, iron deficiency remains an important problem. Prevalence of iron deficiency is still high, even among economically privileged infants. Not only microcytic anemia but also adverse effects on growth, behavior, intestinal function, energy metabolism, and immune function may result with deficiencies of the many important ironcontaining compounds in the body.

Infants are at highest risk for iron deficiency because initial iron endowment is often low, iron needs for growth are high, and foods in infants' diets usually are poor iron sources or impair iron absorption. In addition, the frequent infections typical in infants impair iron absorption when needs remain high.

By taking a careful history and using simple laboratory screening procedures, the pediatrician can identify a large proportion of those who will benefit from iron supplementation. Avoiding foods impairing iron absorption, continuing intake of foods with relatively large amounts of bioavailable iron, and giving additional iron supplementation to particularly highrisk infants can further decrease the prevalence of iron deficiency and its potentially serious consequences with minimal risk.
The Call: Anticipatory Guidance for the Death of a Family's Newborn
Authors: Drell Martin J.
Published: December 2021

When I arrived home, my wife told me to call a personal friend of ours who needed some advice. All my wife knew was that our friend, Mary, had just found out that the baby she was about to deliver was deformed and might not live. Mary wanted to talk with me about how to handle the matter with Barry, her son who was nearly 4 years old.

Calls like this are always difficult ones, and it was with some trepidation that I called. Mary answered. Her voice quivered as she talked. The history unfolded piecemeal throughout the one-half hour phone call.

From the beginning, Mary believed that something was wrong with her pregnancy, that somehow it had not "felt right" From a medical stadpoint, however, there were only minor problems. At the beginning of the third trimester, she had a short period of spotting. The obstetrician had Mary lie down and not exert herself. During this period of rest, Barry was told specifically not to jump on his mother, because it might hurt the baby. The spotting did not recur and the pregnancy progressed, supposedly without a hitch. As the delivery time approached, sonography was done to check on the health of the fetus. The test was done because of the mother's past history of having delivered Barry prematurely and having had a subsequent miscarriage.
What's New in 1987?
Authors: H. R. J.
Published: December 2021

This issue begins year 9 of the Academy's Pediatric Review and Education Program and Pediatrics in Review, or, as it is officially designated, PREP 2—year 3. The topic areas for this year are neonatology, cardiology, genetics and dysmorphism, and health supervision during infancy.

As in the past, the majority of articles planned for this year address educational objectives directed at these topics, and the abstracts are usually used to present material concerning the recent advances educational objectives. In a few instances, recent advances objectives serve as the basis for articles and, in rare instances, I recruit papers with no specific educational objectives. You might call this the Editor's prerogative! One of these appears in this issue, "Health Care Systems: A Pediatric Perspective," by Blim and Matlin. It addresses the important topic of new methods of organization and payment of pediatricians. Nearly 2 years ago, the Executive Board of The American Academy of Pediatrics authorized us to present occasional papers on socioeconomic issues of pertinence to pediatricians in Pediatrics in Review. This and the previously published article by Robertson on medical liability (1985;6:229) are our response to date. We will have more such articles in the future.

Starting with this issue, you will find brief biographies of the authors of the review articles.
Cyanosis in the Newborn
Authors: Lees Martin H. , King Douglas H.
Published: December 2021

RECOGNITION OF CYANOSIS IN THE NEWBORN

Clinical cyanosis is chiefly dependent on the absolute concentration of reduced hemoglobin in the blood rather than on the oxygen saturation. Thus, when there is more than 3 g of reduced hemoglobin per deciliter of arterial blood, central cyanosis should be recognizable. The O2 saturation when clinical central cyanosis becomes apparent varies from about 62% when the hemoglobin is only 8 g/dL to about 88% saturation in the polycythemic infant with a hemoglobin of 24 g/dL.

The normal relative polycythemia of newborn infants (hemoglobin 14 to 20 g/dL), therefore, facilitates recognition of cyanosis.

Recognition of cyanosis in the newborn is rendered more difficult by the presence of fetal hemoglobin (Fig 1). The ratio of fetal to adult hemoglobin varies from infant to infant, and the proportions of each hemoglobin affect the oxygen saturation resulting at any give Pao2. Thus, if a baby with a pH of 7.4 and a temperature of 37°C has mostly adult hemoglobin, central cyanosis (arterial saturation 75% to 85%) will be observed at a Pao2 of 42 to 53 mm Hg, whereas if the baby has mostly fetal hemoglobin, central cyanosis will be observed at a Pao2 of 32 to 42 mm Hg. Thus, the newborn with a high proportion of fetal hemogolobin may have a serious reduction in oxygen tension before central cyanosis is clinically apparent.
Myocarditis in Children
Authors: Hohn Arno R. , Stanton Robert E.
Published: December 2021

Acute myocarditis may go undetected. Nearly half of the known cases of myocarditis are caused by coxsackie B virus. Findings in myocarditis are often nonspecific. Echo cardiograms show reduced function. Some cases of myocarditis progress to cardiomyopathy.
When Pediatric Patients Become Parents
Authors: Weitzman Michael
Published: December 2021

In the past year a number of my adolescent patients have had children of their own. Many of these adolescents had been patients of mine for as many as 10 years prior to their becoming pregnant. My own transition in caring for their children has been surprisingly difficult.

Working in a hospital-based primary care center, I have cared for many children of teenaged parents, but only recently have patients whom I have known for most of their childhood reached an age at which they are becoming parents. In subtle but certain ways, I have had more difficulty with teenaged parents with whom I have a long-term relationship than I have had with teenaged parents with whom I have had no prior experience.
Newborn Infants With Drug Withdrawal Symptoms
Authors: Chasnoff Ira J.
Published: December 2021

The overall incidence of substance abuse is stable for all drugs except cocaine which is steadily increasing in popularity in all aspects of the population. Signs of neonatal abstinence are seen to varying degrees in infants exposed to any of the drugs of abuse. Polydrug use by pregnant women is the most common form of substance abuse, and this complicates the evaluation of the newborn infant. Infants exposed in utero to cocaine are markedly tremulous and irritable and have an increased rate of prematurity. All infants delivered to substance-abusing mothers should be considered at increased risk for sudden infant death syndrome and evaluated accordingly.
New records of Passiflora from Itatiaia National Park, Brazil
Authors: Sarmento Suellen Nunes , Mezzonato-Pires Ana Carolina , Trovó Marcelo
Published: December 2021

We present new records of Passifloraceae sensu stricto from Itatiaia National Park, Brazil, contributing new data on the geographic distribution of four Passiflora L. species to the flora of Brazil: P. deidamioides Harms, P. miersii Mast., P. rhamnifolia Mast., and P. setulosa Killip. The last three species are reported from Itatiaia National Park and the last species from the state of Rio de Janeiro for the first time.
The appeal procedure in the general administrative proceedings (vol. 1 and vol. 2), edited by M. Bogusz (Gdańsk 2019, vol. 1 – pp. 161; vol. 2 – pp. 175) – review article
Authors: Skóra Agnieszka
Published: December 2021

The aim of the description is the rating the monographs Postępowanie odwoławcze w ogólnym postępowaniu administracyjnym (vol. 1 i vol. 2) edited by M. Bogusz and having an in-depth discussion with some of the views expressed in it. The review article formula seems to be appropriate as the reviewed study is the source of a number of issues of interest in theoretical and practical terms. The monograph thus encouraging the discussion and deepening of the arguments presented by the authors. The limited formula, usually intended for reviews, does not seem to be sufficient in this case. In particular, this study discusses the Authors' views on the issues related to the waiver of appeal, views on the determination of the legal nature of the decision of the appeal administrative authority under Art. 138 § 4 of the Administrative Proceedings Act of 1960, the validity of the prohibition of reformationis in peius in the event of a change in the legal situation of a party as a result of issuing this decision by the appeal administrative authority, and the proper application of the provisions on appeal proceedings in proceedings initiated by lodging a complaint. In some places, the argumentation presented by the authors of the monograph was supplemented.
Philosophy within the contemporary practice of American medicine. Various forms of the relationship between both disciplines: Edmund D. Pellegrin's approach
Authors: Czaja Maksymilian
Published: December 2021

The paper presented here illustrates the issue of philosophy within the contemporary practice of American medicine. Four forms of relationship between both disciplines will be discussed: philosophy and medicine, philosophy within medicine, medical philosophy, and philosophy of medicine. The aim of the paper is to illustrate the specificity of the proposed forms of relationship, i.e. the contrast between the autonomous approach of the both disciplines and the realistic philosophy of medicine promoted by Edmund D. Pellegrin, which closely links the issue of the nature and theory of medicine with the undertaking of philosophical reflection. The issue of the topicality of Edmund D. Pellegrin's philosophy of medicine in the context of the current challenges of American health care will also be discussed.
Stanisław Leśniewski’s understanding of the role of formal language of mathematics
Authors: Miszczyński Ryszard
Published: December 2021

Formalism used by Leśniewski to present mathematical theory is called a radical one. According to the author, it is the implementation of the postulates of the so-called formal arithmeticians. Mathematical theory is presented as a pure game of formulas devoid of content. It is governed by the precise rules described in the metalanguage. The author stresses the difference between Leśniewski’s and Hilbert’s mathematical approaches.
Urgent-Start Peritoneal Dialysis: A Comparison of Catheter Insertion Using Seldinger Technique and Surgical Operation
Authors: C Yu , N Yang , K Wang , H Lin , L Li
Published: December 2021

Background: Urgent-Start Peritoneal Dialysis (USPD) is increasingly used worldwide and represents a safe, convenient and cost-effective method to initiate dialysis. However, good catheter insertion techniques are imperative to avoid postoperative complications. While percutaneous catheter insertion by Seldinger technique is considered a safe method with few post-operative complications, comparisons with surgical operation technique are needed, especially in China, where there a few reports on the outcome of percutaneous catheter insertion by Seldinger technique in USPD patients.
Initiation of Antiretroviral Therapy in HIV Elite Controller: A Case Report from Limpopo Province, South Africa
Authors: VM Muthambi , KG Ndzeru , NG Mbenenge , CG Adu-Gyamfi
Published: December 2021

Elite Controllers (ECs) are a less frequent but distinct group of HIV infected patients. Recent treatment guidelines encourage ART initiation in all HIV-infected individuals as early as 2 possible to control the infection and prevent transmission. Initiating ART in ECs remains controversial, although there are multiple hypothetical benefits. Currently, there is evidence that ECs must be initiated on ART in order to prevent non-AIDS related comorbidities associated with immune activation. Clinicians are to weigh the risks and benefits of initiating ART as well as monitor the patients for effective therapy. In this case report, we present an HIV management dilemma of an EC, a middle-class South African woman from the Limpopo province.
Neuropsychological Characteristics of Adults with HIV: A Systematic Review
Authors: CC Natalia , SR Ana Natalia , YT Ma Guillermina
Published: December 2021

Introduction: HIV-Associated Neurocognitive Disorder (HAND) is frequently reported even in patients undergoing Antiretroviral Therapy (ART), however, its severity, the main affected domains, and its relationship with ART are not well understood.
Invisible Audience and Echo Chamber Effects
Authors: Morelock Jeremiah , Narita Felipe Ziotti
Published: December 2021

Developing a theory for the remote audiences of digital networks, we dialogue with social psychology and social theory to describe a novel form of communication that is delivered to everyone and no one at the same time. This is the invisible audience. At the same time as people express themselves to a generalized, invisible audience over social media, the ‘everyone’ of this invisible audience is often narrowed in a very specific way: echo chamber effects. The invisible audience and echo chamber effects both reinforce a solipsistic horizon for every person, and these individual horizons come partially together under echo chamber effects, constituting a multiplicity of separate ‘homophilic assemblages’ characterized by normative and political alignment, one-dimensional communication, and black-and-white thinking. We call this a ‘splitting public sphere’. On the whole, rational debate is curtailed, under the reign of soundbites, memes, and angry venting. The lack of exposure to reasoned disagreement makes people more susceptible to authoritarian rhetoric and propaganda.
Authoritarianism and Resistance
Authors: Morelock Jeremiah , Narita Felipe Ziotti
Published: December 2021

We tie together and explicate the political implications of the trends discussed in previous chapters. For Fromm, sadomasochistic desires are bred from modern alienation, and these desires can fuel authoritarian social movements. For Foucault, modern authoritarianism (and genocide) is fed by the idea that the state needs to protect the normal majority from the abnormal minority (biopolitics). Giddens says in ‘late modernity’ people distrust experts, long for authenticity, lose concern with morality and fixate on avoiding risk. With the rise of global social networks, there is also a lot of reaction against globalisation. Facing porous national boundaries, many people push back against multiculturalism, seeing it as a threat to their social order. Providing examples from different countries, we describe how in other, more direct ways, social media plays into authoritarian populist ends that subvert liberal democracy. We suggest that when political leaders use Twitter and Facebook they too can project spectacular selves, and post messages that make them appear more authentic and connected to ‘the people’. At the same time, social media also offers new channels and tools for protest, activism, and anti-authoritarianism. The ‘agitation games’ of authoritarian political figures inspire their own opposition as part of their method of inspiring their own movements. Authoritarianism is a growing reality, but so is anti-authoritarianism.
Conclusion: A Turning Point for Liberal Democracy
Authors: Morelock Jeremiah , Narita Felipe Ziotti
Published: December 2021

Digital networks have unified contemporary geoculture around market expansion and the spectacle. The society of the selfie, as a sociotechnical complex that has emerged from the capitalist transformations since the 1980s, is the quintessence of a new structure for human relatedness. The introduction of new communication technologies always works in two directions at once—we become more connected in some ways, more alienated in others. The story of Web 2.0 and the discontents of the society of the selfie are, in this sense, a different genre of the same basic tendency. The society of the selfie is not the cause of this widespread immiseration, but it is historically inseparable from it, and in some significant ways contributes to the social changes and dislocations that authoritarian movements react against with their militant retrotopic visions. Yet the desire for progressive change to a more inclusive, egalitarian form of society is influenced by the same dislocations and crises that impact the authoritarians, in this case the cosmopolitans and anti-capitalists reacting not just against economic deprivation but also against a competitive, reified social world that has imposed rigid norms about work, strength, and individualism, while depriving them of belonging, cooperation, and ‘the good life’. If the society of the selfie favours threats that reify contemporary sociality and warp communication dynamics, it also feeds mechanisms of engagement and the production of new social ties, as well as new expectations for participation and empowerment in society.
ZORUNLU GÖÇMEN GRUPLARIN TOPLUMSAL VE SPOR AKTİVİTELERİNDE SOSYAL UYUM VE ÇOK KÜLTÜRLÜLÜK ALGISI: SAMSUN İLİ ÖRNEĞİ
Authors: ÇANKAYA Soner , TOZLU Betül
Published: December 2021

Bu çalışmanın amacı, zorunlu göçmen grupların toplumsal ve spor aktiviteleri neticesinde, sosyal uyum ve çok kültürlülük algılarının incelenmesidir. Çalışma grubu, Samsun ilinde ikamet eden 12-25 yaş grubu mülteci öğrenci ve sivillerden oluşmaktadır. Çalışmada, deney grubundaki katılımcılara sportif faaliyet öncesi uygulanan “Sosyal Uyum Kendini Değerlendirme Ölçeği” (SUKDO) ve “Çok kültürlülük Algı Ölçeği” (ÇAÖ) toplam puanları arasında zayıf; faaliyet sonrasında ise orta düzeyde pozitif bir ilişki olduğu tespit edilmiştir. Sportif faaliyetle, SUKDO açısından kritik ve sorun kategorisindeki kişilerin yaklaşık %50’sin normalleşme kategorisine, ÇAÖ ise, düşük kategorideki 23 kişiden 5’i, orta durumdaki 105 kişiden 12’si yüksek kategoriye geçtiği belirlenmiştir. Dolayısıyla, bu çalışma bulgularına göre bir toplumsal değişim süreci yaşayan zorunlu göçmen grupların spor faaliyetlerine katılımlarının sosyal ilişkilerin temelini oluşturan çok kültürlü toplumlarda sosyal uyumun sağlanmasına katkı sağladığı söylenebilir.
GÜVENLİ HAREKET STRATEJİSİ: ANTİ-HAREKET FELSEFESİ (GELENEKSEL DERLEME)
Authors: ÇINARLI Fahri Safa , KAFKAS Muhammed
Published: December 2021

Bu araştırma, lumbopelvik-kalça kompleksi olarak tanımlanan kasların optimizasyonunda, potansiyel güvenli egzersiz stratejisi olabilecek anti-hareket egzersiz yaklaşımının incelenmesi amacıyla geleneksel derleme türünde yazılmıştır. Yayımlanma yılı sınırlaması olmaksızın Google Akademik, PubMed ve Scopus arama tabanlarından “core exercise, safe exercise, spine and exercise” İngilizce anahtar kelimeleri kullanılarak konu ile ilişkili makaleler ele alınmıştır. Araştırma, sistematik derlem türünde yazılmadığı için tüm literatür makaleleri incelenmemiştir. Fitness sektöründe merkezi bölgeye yönelik egzersiz rutinlerine rastlamak mümkündür. Ancak tekrarlı eğilme-bükülme hareketlerinin omurgada herniasyona yol açtığı iddia edilmektedir. Yanlış uygulama kaynaklı yapısal deformitelere bağlı olarak gelişen bel ağrısı görülme oranında artış olduğu bilinmektedir. Epidemiyolojik olarak genellikle posterior zincir hattındaki instabilite veya spesifik olarak zayıf lomber omurga kaynaklı rahatsızlıklara toplumun büyük bir bölümünde rastlamak mümkündür. Diğer taraftan merkezi bölgenin gelişmesinde alternatif güvenli ve etkili egzersiz metodolojilerine ihtiyaç duyulmaktadır. Bu noktada, anti-hareket yaklaşımının omurga sağlığını ön planda tutan güvenli egzersiz stratejilerinden bir tanesi olabileceği düşünülmektedir. Bu beklentinin dayanağı, egzersiz sırasında vertebral sütunun mekanik olarak minimal iç dirence maruz kalmasıdır. Anti-hareket uygulamalarında, omurga güvenli aralık olarak isimlendirilen sınırlarda kalmakta ve dış kuvvetlere karşı moment kuvveti meydana gelmektedir. Omurganın güvenli sınırlar içerisinde tutulması ile vertebral deformitelerin veya mekanik olarak hareket kaynaklı pek çok negatif geri-bildirimin önlenebileceği düşünülmektedir. Derlemede anti-hareket uygulamalarının terminolojisinden, mekanizmalarından ve egzersiz katılımcıları açısından potansiyel progresyon stratejilerinden bahsedilmektedir. Egzersiz katılımcıları kendi sınırlılıkları veya beklentileri doğrultusunda farklı ekipman veya çoklu düzlemlerde uygulanan yeni anti-hareket kalıpları geliştirebilirler ve böylece egzersizden maksimum verim elde edebilirler.
ÖĞRETMENLERİN DAVRANIŞSAL GÜÇLENDİRİLMESİ İLE ÖRGÜTSEL ADANMIŞLIKLARI ARASINDAKİ İLİŞKİ
Authors: ERTÜRK Ramazan , AKGÜN Nuri
Published: December 2021

Bu araştırmanın amacı, öğretmenlerin davranışsal güçlendirilmesi ile örgütsel adanmışlık algılarını belirlemek ve bunlar arasında anlamlı bir ilişki olup olmadığını ortaya koymaktır. Araştırma, ilişkisel tarama modelinde tasarlanmıştır. Araştırmanın çalışma evrenini Bolu ili merkez ilçede bulunan resmi ilkokul, ortaokul ve liselerde 2020-2021 eğitim-öğretim yılında görev yapan öğretmenler oluşturmuştur. Araştırmada veri toplama aracı olarak "Kişisel Bilgi Formu", "Öğretmenlerin Davranışsal Açıdan Güçlendirilmesi Ölçeği" ve "Öğretmenlerin Örgütsel Adanmışlık Ölçeği" kullanılmıştır. Araştırma sonuçlarına göre, öğretmenlerin davranışsal güçlendirilme algıları ölçek genelinde ve boyutlarında "çoğu zaman" düzeyinde; örgütsel adanmışlık algıları, ölçek genelinde ve boyutlarında "yüksek" düzeydedir. Davranışsal güçlendirme ölçeği ve boyutları ile örgütsel adanmışlık ölçeği ve boyutları arasında pozitif yönlü anlamlı ilişki vardır.
FLASH-seq protocol (V1) v1
Authors: Picelli Simone , Hahaut Vincent
Published: December 2021

The single-cell RNA-sequencing (scRNA-seq) field has evolved tremendously since the first paper was published back in 2009. While the first methods analysed just a handful of cells, the throughput and performance rapidly increased over a very short timespan. However, it was not until the introduction of emulsion droplets methods, that the robust and reproducible analysis of thousands of cells became feasible. Despite generating data at a speed and a cost per cell that remains unmatched by full-length protocols like Smart-seq, scRNA-seq in droplets still comes with the drawback of addressing only the terminal portion of the transcripts, thus lacking the required sensitivity for comprehensively analyzing the transcriptome of individual cells. Building upon the existing Smart-seq2/3 workflows, we developed FLASH-seq (FS), a new full-length scRNA-seq method capable of detecting a significantly higher number of genes than both previous versions, requiring limited hands-on time and with a great potential for customization.