bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capillary Blood Flow to the Skin of Forearm in Cirrhosis
Authors: Carrella Massimino , Hunter John O. , Fazio Serafino , Del Piano Concetta , Cannada Bartoli Giuseppe 
Published: November 2007

In liver cirrhosis a hyperkinetic circulatory state is frequently observed as a consequence of an arterial or even a venous peripheral vasodilatation with sec ondary increase in cardiac output. Indirect evidence suggests that, in liver dis ease, the manifestation of warm hands, capillary pulsation, or palmar erythema may also relate to such a state by way of an increased skin blood flow. The purpose of the present study has been to directly assess capillary skin blood flow in liver disease through the clearance of a locally injected radioactive substance. The study was performed in 24 patients with different liver diseases, includ ing 14 Child class II cirrhotics, and in 9 control subjects. A small volume of Na131I solution was injected at the volar surface of the forearm, and radioactive counts were recorded continuously for ten seconds every minute for up to twenty minutes. The best fit line of the disappearance rate was determined by the least square method, and both its T/2 and an estimated blood flow parame ter were calculated. The T/2 of isotope disappearance rate was 4.54±0.71 and 4.38±0.68 minutes in cirrhotics and controls, respectively. Similarly, estimates of skin blood flow (mL/min/100 g tissue) were 7.82±1.28 in the cirrhotic pa tients, not significantly different from those in both patients with mixed liver diseases (7.6±2.86) and control subjects (8.06 ± 1.04). Parameters of skin blood flow were also invariant in respect to the various etiologies of liver disease. Thus, the present findings indicate that capillary skin blood flow is not af fected by the hyperdynamic circulatory changes occurring in liver cirrhosis. Likely, such changes mostly relate to more proximal circulatory variations oc curring at the level of arteriovenous anastomoses.
Automated Blood Pressure Determination During Exercise Test. Clinical Evaluation of a New Automated Device
Authors: Modesti Pietro Amedeo , Carrabba Nazario , Gensini Gian Franco , Bonechi Francesco , Taddei Tamara , Malfanti Pier Luigi 
Published: November 2007

The accuracy and reproducibility of a new automatic device (P) specially designed for noninvasive blood pressure monitoring during the exercise stress test were evaluated in 50 consecutive subjects (34 normotensives and 16 hyper tensives). Automatic measurements were compared with those taken by a sphygmomanometer (RR). A good agreement between systolic pressure values obtained by the two methods was found (RR 159±30 mmHg, P 158 ± 28 mmHg, mean difference = -1.53 ± 13 mmHg, p = 0. 166, ns). On the contrary the new device significantly underestimated diastolic pressure values (RR 89.3 ± 13 mmHg; P 84±13 mmHg, mean difference -5.37±9.3, p < 0.001). In conclusion the new device seems able to measure systolic but underesti mates diastolic blood pressure both in hypertensives and in normotensives dur ing the effort test.
The Child with School Problems
Authors: Blanche Bourne I. 
Published: November 2007

Failure in school affects about 20 per cent of school children, and is an important problem for medical consideration in that the reason for failure is often a diagnostic challenge. In large metropolitan areas many of the school problems en countered are the result of the emotional condition, which fre quently has a direct relationship to the socia-economic or socio- cultural background or both. These are most often problems related to mental health rather than deviations from physical health. Much more knowledge is needed in this area of mental health.
Sex and the Adolescent
Authors: Calderone Mary S. 
Published: November 2007

The Sex Information and Education Council of the United States (SIECUS) is a new and much-needed voluntary organi zation which every pediatrician should know about and support. SIECUS proposes that our society needs to develop new atti tudes about human sexuality and its role in the life of man. To achieve this will give help to the adolescent, but also will re quire the help of the adolescent.
Sudden Unexpected Death in Infancy A New Hypothesis of Cause
Authors: Stowens Daniel , Callahan Edward L. , Clay Jennifer 
Published: November 2007

Blood and urine studies were performed on 30 consecutive infants who came to autopsy in 1963 after sudden unexpected death. In every case, a constellation of anatomic alterations was found which is identical with that seen in experimentally induced anaphylaxis in animals. Urine analyses revealed intense proteinuria at the time of death and the presence of an abnormal urinary compound termed a "nephrosis peptide." These authors hypothesize a physio logic defect leading to the absorption of undigested protein. This study suggests that this protein, being antigenic, is re sponsible for a lethal anaphylactic reac tion, thereby explaining the sudden death of some infants.
Precocious Puberty, IQ and School Acceleration
Authors: Money John , Neill Jeffrey 
Published: November 2007

School acceleration was recommended in 20 of 45 cases of idiopathic sexual pre cocity, and carried through in 12 of those cases. The accelerated children all were academically successful. School acceleration is recommended as part of a more general program of accel erating social development, in order to help the precocious child bridge the gap between chronologic age and physique age. A high IQ facilitates acceleration, but an average IQ does not necessarily forbid it. The child's own effort to achieve and a favorable parental attitude are important. School authorities in some places do not understand the nature of the problem and refuse to cooperate.
Review : Disorders of the Red Cell Membrane
Authors: Neerhout Robert C. 
Published: November 2007

Morphologically similar cells can be seen in such varied conditions as liver disease, renal disease, a-betalipoproteinemia, malab sorption states, congenital nonspherocytic anemias, thalassemia, iron deficiency, pykno cytosis, hemolytic-uremic syndrome, erythro cyte enzyme deficiencies, etc.The common denominator in these condi tions may be an increase in membrane rigid ity, resulting from a diversity of causes. These would include altered protein-lipid- carbohydrate composition, abnormally struc tured hemoglobins, the presence of Heinz bodies due to altered glycolysis or unstable hemoglobins. The end result of such altered membrane elasticity, regardless of cause, would be fragmentation and destruction of the red cells during passage through small vascular channels, particularly in the spleen. Changes in erythrocyte stromal composi tion often seem to reflect more generalized systemic metabolic disorders. Whether any of the alterations of membrane composition are causally related to either the morpho logic changes or the shortened cell survival still remains to be proven.
Respiratory Distress Syndrome
Authors: Graw Robert G. , De'ak William R. 
Published: November 2007

This program, in use at the Los An geles Children's Hospital, brings together information previously scattered through the literature under such topics as tem perature regulation, newborn manage ment, acid-base balance, and respirator care. It standardizes the approach to these infants and clarifies the following points: 1. Evaluation of the clinical status and estimation of the prognosis with re spect to required treatment. 2. Blood sampling. 3. Interpretation of laboratory results. 4. Use of alkalinizing agents for acid- base correction. 5. Use of oxygen, endotracheal tubes and respirators.
The Clumsy Child
Authors: Illingworth R.S. 
Published: November 2007

Clumsiness is not a clinical diagnosis. It is merely a symptom due to a wide vari ety of causes. Clumsiness in children can result in be havior problems because of ridicule, unkind ness and discouragement, and the child's inability to keep up with his fellows in sport. Bad writing is especially liable to lead to emotional problems because the teacher is apt to blame the child for laziness and carelessness. The main principle in treatment is the correction of harmful attitudes towards the child—by making it clear to parents and teachers that the child has a genuine neuro logic deficit and he cannot help it.
Jejunal Biopsy in Celiac Disease
Authors: McNicholl Brian , Egan Bridget 
Published: November 2007

When symptoms suggestive of celiac dis case have been present for over three months, irrespective of tests of absorptive function, a jejunal biopsy is indicated, but this should be preceded by at least a week of a gluten-containing diet. If severe mucosal damage is found, a gluten-free diet should be prescribed for several years, and in many cases must be continued until growth has ceased. Equivocal findings, which are most likely in the early months of the disease, call for further assessment including repeat biopsy when symptoms persist on a gluten-contain ing diet.
Maternal Anxiety and Infantile Colic
Authors: Carey William B. 
Published: November 2007

Is maternal anxiety a primary cause of in fantile colic, or is it merely a result of the colic? The problem is perplexing because to date all studies but one 1 have investi gated the situation retrospectively, after the onset of colic. In addition, confusion has re sulted from vague definitions of colic and inadequate assessments of maternal emo tions. This study carefully defines colic, investi gates maternal anxiety in the immediate postpartum period, and then compares the anxiety with the presence or absence of colic during the first four months. All interviews and examinations and the evaluation of the data were done in the course of a busy prac tice by a pediatrician with a special interest in child behavior. Forty mothers expressed some anxiety. There was significantly more colic among their babies (27.5%) than among the babies of 63 mothers without anxiety (3.2%).
The Synacthen Test of Adrenal Cortical Function in Children
Authors: Davidson A.G.F. , Johnston Carden 
Published: November 2007

Adrenal cortical function was assessed in a dozen children by measurement of plasma cortisol rise after a single injection of the synthetic polypeptide Synacthen (β1-24 cor ticotropin), and by measurement of urinary 17 hydroxycorticosteroid response to a three- day stimulation with ACTH. Statistically significant correlation between the results of these two tests indicates that the Synacthen test is a valid and useful ap proach to appraising adrenal cortical funç tion in children. The Synacthen test possesses a number of advantages over the ACTH test—the test substance is purer, the results are obtained much more quickly, and the risk of ana phylactic shock is eliminated.
Toward an Understanding of Teenagers
Authors: Chanin Arnold 
Published: November 2007

Drug abuse has plagued human society throughout recorded history. The urgency of the problem today is reflected in the flood of newspaper, magazine and medical articles. The greatest tragedy is that our younger citizens are most involved. To understand any teenager's turn to drugs, one must understand teenagers— their problems, their aspirations, and their complex emotions. Dr. Chanin, a noted artist as well as physician, provides new insights and offers fresh alternatives to drug abuse.
Office Electrocardiography in General Pediatrics
Authors: Miller B. Lynn , Gessner Ira H. , Schiebler Gerold L. 
Published: November 2007

This article—part I of a monthly series—outlines succinctly the bases for the ECG changes in the normal growing infant, and highlights a few helpful ground rules and specific points of normal and abnormal tracings. Subsequent articles deal with the following aspects: II. Evolution of the ECG from Birth to One Year III. Cardiac Chamber Enlargement IV. Arrhythmias—Premature Beats and Fast Heart Rates V. Arrhythmias (cont.)—Pauses and Slow Heart Rates VI. ECG after Cardiac Surgery VII. Miscellaneous—Normal Variants, Electrolyte Effects, New Applications of Electrocardiography 1. Burch, G. E. and DePasquale, N. P.: Electrocardiography in the Diagnosis of Congenital Heart Disease. Philadelphia, Lea and Febiger, 1967. 2. Cassels, D. E. and Ziegler, R. F.: Electrocardiography in Infants and Children. New York, Grune and Stratton, 1966. 3. Guntheroth, W. G.: Pediatric Electrocardiography. Philadelphia, W. B. Saunders Co., 1965. 4. Krovetz, L. J., Gessner, I. H. and Schiebler, G. L.: Handbook of Pediatric Cardiology. New York, Hoeber Medical Division, Harper and Row, 1969, pp. 70-94.
The Reliability of Maternal Recall
Authors: Hoekelman Robert A. , Kelly John , Zimmer Anne W. 
Published: November 2007

Fifty-nine mothers were asked, when their babies were nine months of age, to recall the baby's birth date, birth weight, last recorded weight, past illnesses, illness visits, well-baby visits, and immunization history. These responses were checked against the data recorded in the baby's clinical records to determine the accuracy of the mothers' recall. Maternal education did affect the accuracy of recall while maternal age, race, and the sex and birth order of the baby did not. Health and illness related historical events require ongoing documentation in some easily retrievable form if they are to be relied upon by physicians and medical investigators when providing care or conducting research.
Absorption of Vitamin A in Patients with Cystic Fibrosis
Authors: Warwick Warren J. , Hansen Leland G. , Sharp Harvey 
Published: November 2007

Vitamin A absorption tests using vitamin A palmitate and alcohol separately in oil and oil-water emulsions were done on 43 patients with cystic fibrosis. Patients were given 7,000 units of vitamin A per kilogram of body weight with a fatty breakfast. Pancreatic enzymes were not given with the test meal and were withheld for five hours from start of test. Blood was drawn before administration of the vitamin and at three and five hours after administration. Serum vitamin A levels were estimated using the Carr-Price technique. The percentages of patients with normal vitamin A absorption were 85 with vitamin A alcohol in oil-water emulsion, 61 with vitamin A alcohol dissolved in oil, 64 with vitamin A palmitate in oil-water emulsion, and 19 with vitamin A palmitate in oil. The number of stools per day is an inverse indicator of retention time in the intestine. Absorption of fat soluble vitamins is always abnormal when a patient has four or more stools a day. The observations that cystic fibrosis patients with abnormal liver biopsies have poor absorption of vitamin A were not statistically significant. The ques tion of the effect of cirrhosis in cystic fibrosis on vitamin A absorption re mains unresolved.
"Alice in Wonderland" Syndrome as a Presenting Symptom of Infectious Mononucleosis in Children
Authors: Copperman Stuart M. 
Published: November 2007

Three cases of "Alice in Wonderland" syndrome (metamorphopsia) are presented and described as a presenting symptom of infectious mono nucleosis in a preadolescent male and in two late teenage females. In each instance, the classical infectious mononucleosis symptoms and diagnosis followed the onset of visual aberration. Thorough physical and blood examination of patients who present with such a syndrome must be undertaken before these symptoms are ascribed to psy chiatric abnormalities. It is emphasized that infectious mononucleosis is a diffuse disorder, often associated with encephalopathies, which may include visual imbalance symptoms.
Orbital Involvement in Acute Sinusitis
Authors: Hawkins Donald B. , Clark Richard W. 
Published: November 2007

The possibility of acute bacterial sinusitis should be considered in any child with sudden swelling about the orbit. Management is determined by the stage of the disease as well as by the sinus predominantly involved. Extraocular movements and proptosis are the best guidelines for therapy. When there is no proptosis and extraocular mobility is normal, conservative therapy with intravenous antibiotics and nasal deconges tants is usually effective. When ocular mobility is impaired or proptosis develops, intranasal or external surgical drainage are usually required. Of 24 patients summarized in this paper, the ethmoid was the predominantly involved sinus in 12, the frontal in 7, the maxillary in 5. Only 4 of the 12 with predominant ethmoiditis required surgery. Of the 5 with predominant maxillary sinusitis, 2 required surgery. All 7 were pre dominant frontal involvement needed surgical drainage.
A Bleeding Syndrome in Infants due to Acquired Prothrombin Complex Deficiency
Authors: Bhanchet P. , Tuchinda S. , Hathirat P. , Visudhiphan P. , Bhamaraphavati N. , Bukkavesa S. 
Published: November 2007

A bleeding syndrome due to severe prothrombin complex deficiency is reported in 93 infants. Most were breast fed (98 per cent), aged 2 weeks to 1 year and there were no serious preceding or associated diseases. Hemor rhagic diathesis, pallor and mild hepatomegaly were the major manifesta tions. The incidence of intracr nial bleeding was strikingly high (63 per cent) particularly with subdural and subarachnoid hemorrhage. Acute onset, short course and rapid clinical and laboratory improvement after vitamin K therapy were observed. Mortality rate was 35 per cent but has been reduced to 17 per cent since 1969. The location of bleeding, prompt diagnosis and early treatment are the major factors affecting prognosis. Severe prothrombin complex deficiency due to vitamin K deficiency ac counted for the pathogenesis of bleeding. Possible causes of vitamin K deficiency were discussed but definite conclusions could not be drawn.
Do Stimulant Drugs Improve the Academic Performance of Hyperkinetic Children?
Authors: Barkley Russell A. , Cunningham Charles E. 
Published: November 2007

Stimulant drug studies based primarily on measures of teacher opinion have frequently concluded that these drugs improve the achievement of hyperkinetic children. However, a review of those studies using more ob jective measures of academic performance revealed few positive short- term or long-term drug effects on these measures. What few improvements have been noted can be readily attributed to better attention during testing. The major effect of the stimulants appears to be an improvement in classroom manageability rather than academic performance. It would seem that the stimulants are not able to influence those etiologic factors, other than overactivity and inattentiveness, which predispose hyperkinetic children toward school difficulties. Hence, since the goal of pediatric intervention with these children should be to enhance school per formance as well as reducing hyperactive behavior, the two should be independently and objectively monitored. Since stimulant medications fail to improve the academic performance of most of these children, additional educational assistance must be provided.
Neonatal Sepsis Resulting from Possible Amniotic Fluid Infection
Authors: Philip Alistair G. S. 
Published: November 2007

Antibiotics are frequently prescribed "prophylactically" when the neonate is considered to be at risk for infection. The risk factors of prolonged rupture of membranes (>24 hours), maternal fever/infection, and/or unexplained preterm labor (suggesting possible amniotic fluid infection) were investigated in 276 babies. Only two of 150 babies investigated for a single factor proved to have sepsis, while of the 126 babies who had multiple factors, 13 had sepsis. Several laboratory tests, used singly or in combination, were more helpful than clinical manifestations in predicting which babies were likely to be infected. Neo natal sepsis was present in 6 per cent of the total, in 10 per cent of neonates with clinical signs, in 21 per cent with an increased immature/total neutrophil ratio (I/T ratio ≥ 0.2), and in 36 per cent of infants with a positive "sepsis screen." The incidence of "infection" (sepsis and "very probable" infection) was 12 per cent overall, but was 14 per cent with neonatal signs, 44 per cent with I/T ratio ≥0.2, and 74 per cent in those with a positive sepsis screen. A leukocyte count < 5,000/ cu mm and/or an I/T ratio ≥ 0.2 was 100 per cent sensitive for sepsis, but the sepsis screen was most "efficient" at detecting "infection." Starting antibiotics on the basis of risk factors alone does not seem appropriate. In situations where amniotic fluid infection is possible, evaluation with the leu kocyte count and differential (with or without other tests) could decrease the indiscriminate use of antibiotics, particularly when a single risk factor is the reason for suspecting infection.
Sterilization of Infant Formula
Authors: Gerber Michael A. , Berliner Benjamin C. , Karolus John J. 
Published: November 2007

A survey of 237 pediatricians currently practicing in Connecticut revealed that 97 (41%) recommend routine sterilization of infant formula for a mean of 4.4 months. Eight bottles of proprietary formula were prepared in a controlled manner: four utilizing the "terminal heating method" of sterilization and four utilizing the "clean method" without sterilization. While the "terminal heating method" resulted in less bacterial contamination, three of the bottles prepared by the "clean method" had negative coliform counts and the other bottle had a minimal count. Ten bottles prepared without sterilization were randomly selected from mothers who had brought their infants for well-child care. With the exception of a small inoculum of enterotoxin- producing Staphylococcus aureus in one bottle, no enteropathogens were identified. The implications of this study for the routine preparation of infant formula are discussed.
The Impact of Divorce on Teenagers
Authors: Westman Jack C. 
Published: November 2007

Divorce is common in the contemporary way of life and deserves objective study. It may have redeeming features, but from the point of view of children, divorce is a stressful experience because of the disruption of the home and its financial, emotional, and social costs. The adverse impact, however, can be minimized by realistic and sensitive attention to its effects on children. Although divorce alters the living arrangements of affected families, it does not end family relationships. For this reason, marriage and divorce counseling should deal with the perspectives of both adults and children. Most teenagers and their parents adjust to divorce and later regard it as having been a constructive action; but one-third do not. In those instances the turbulence of the post-divorce phase plays a crucial role in influencing pathological reactions in affected teenagers. The phy sician is in a strategic position to act as diagnostician, a clarifier of values, an educator in the facts of family life and divorce, a counselor in working through feelings about and attitudes toward divorce, and a source of support for teenagers.
Incidence of Acute Rheumatic Fever
Authors: Schwartz Richard H. , Hepner Seymour I. , Ziai Mohsen 
Published: November 2007

The incidence of acute rheumatic fever has declined remarkably in the past three decades, but the disease has not been eradicated, as some physicians believe. This study documents the diagnosis of the disease in 23 middle-class children from Fairfax County, Virginia, during the 11-year- period from 1970 through 1980. This county has one of the highest median family incomes in the United States. The annual age-adjusted incidence rate of initial attacks of acute rheumatic fever per 100,000 Fairfax County children declined from 3.0 in 1970 to 0.5 in 1980. In six of the 23 children, carditis accompanied by monarticular arthritis or arthralgia was present. Another seven children had carditis plus polyarthritis. Two patients had Sydenham's chorea. None of the children had erythema marginatum or rheumatoid nodules. In two children, symptoms of acute rheumatic fever developed two weeks after they finished a 10-day course of penicillin for Group A streptococcal pharyngitis. The remaining 21 children had not been considered ill enough to be brought to medical care prior to development of symptoms of acute rheumatic fever.