bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skin Flow The Venoarteriolar Response and Capillary Filtration in Diabetics. A 3-year Follow-Up
Authors: Belcaro G. , Nicolaides A.N. , Volteas N. , Leon M. 
Published: November 2007

Resting skin blood flow (RF) and the venoarteriolar response (VAR = the vasocontrictor response on standing) have been studied in 100 patients with dia betic neuropathy, in 100 diabetics without neuropathy, and in 100 normal sub jects by laser Doppler flowmetry. Capillary filtration was also studied with strain gauge plethysmography. The authors followed up these patients by evaluating their microcirculation again after three years. At the beginning of the study in patients with neuropathy, RF and capillary filtration were increased. The VAR and the microangiopathy index (MI = VAR/RF) were reduced in all diabetics, to a greater extent to those with neuropathy. After three years the authors observed an increase in capillary filtration as sociated with a further impairment in VAR and MI, suggesting progression of microangiopathy in both groups of diabetics. These results suggest that the postural control of blood flow in the skin of the foot is impaired in diabetic microangiopathy, particularly in neuropathics. Increased skin blood flow and capillary filtration and the impaired venoarterio lar response cause edema and may contribute to the thickening of capillary base ment membranes and the progressive evolution of diabetic microangiopathy.
A Four Year Clinical and Echographic Follow-up of Asymptomatic Carotid Plaque
Authors: Fabris F. , Poli L. , Zanocchi M. , Bo M. , Fiandra U. , Fonte G. 
Published: November 2007

Eighty-five patients with asymptomatic carotid plaque—a diagnosis revealed by B-mode high-resolution echotomography—were followed up for four years; the echoplaque changes were compared with the clinical history. Eight patients died (2 from stroke, 4 from myocardial infarction, and 2 from lung tumor) and were excluded from the follow-up. Three patients underwent carotid thromboen darterectomy (TEA) (1 bilateral), and these 4 carotids were not considered in the total series. At the first echo Doppler evaluation of 150 carotids, plaques were observed in 112; 38 vessels were free of lesions. Of the 150 carotids, 8 revealed a new plaques. In regard to the echogenic pattern, 95 of the 112 plaques (84.8%) remained unchanged, 16 (14.3%) progressed, and regression of a small homogeneous plaque was observed in 1 patient (0.9%). An increase of the degree of vascular stenosis, was observed in 23 of the 150 carotids (15.3%). Cerebral ischemic symptoms occurred in 5 patients. In 1 patient who suffered from stroke, a new, soft, dyshomogeneous plaque in the carotid of the side of the lesion was observed. In 3 patients (2 with strokes, 1 with transient ischemic attack) the occlusion of a previous severe stenosis was observed. The fifth pa tient had a stroke on the side of an unchanged, ulcerated hemodynamic lesion. A valid criterion for identifying a risky plaque should be the joint evaluation of the echostructural characteristics and the degree of stenosis.
Viral and Drug Hazards in Pregnancy
Authors: Connelly John P. , Reynolds Stephen , Crawford John D. , Talbot Nathan B. 
Published: November 2007

Should pregnant mothers be immunized against smallpox? Poliomyelitis? What is the incidence of fetal loss or major congenital anomalies if a pregnant woman contracts rubella? Poliomyelitis? Rubeola? Mumps? Or varicella? Is there a relationship to the time of the infection during pregnancy and congenital anomalies? Is there a higher fetal mortality associated with the use of the sulfonylurea drugs for pregnant diabetic mothers? Are progesteroids harmless to the fetus when given to a pregnant woman? Anti-thyroid drugs? Thiazides?
Cystic Disease of Liver and Kidney with Portal Hypertension
Authors: Bradford William D. , Bradford John W. , Porter Stanley , Sidbury James B. 
Published: November 2007

Cystic disease of the liver and kidney has a genetic basis, and is more frequent in females. When portal hypertension accom panies this malformation the patient often presents with sudden, unexpected hemateme sis. Severe or unusual infections, difficult to treat, represent other problems for the clini cian. One of the two patients here described was found at autopsy to have superimposed signs of cytomegalic inclusion disease in lungs and liver.
Psychologic Approach to Psychosexual Misidentity with Elective Mutism
Authors: Money John 
Published: November 2007

Two cases of hyperadrenocortical fe male hermaphroditism illustrate that psy chosexual identity may differentiate inde pendently of genetic, gonadal, hormonal and morphologic sex, and also of assigned sex. One child, assigned as a boy, elected by age 12 to be reassigned as a girl. The other child, assigned as a girl, elected by age 11 to be reassigned as a boy. It was possible to overcome the psychologic handicap of their elective mutism, espe cially by the use, initially, of drawing, writing and modeling. These cases illustrate the general rule that proper weighting must be given to psychosexual differentiation and the sense of gender identity before a decision for or against sex reassignment can be valid. A sex reassignment can be success fully undertaken if it resolves incongruity between gender identity and assigned sex, or if the gender identity is ambivalently noncommittal. Otherwise sex reassign ment is contraindicated.
Treatment of Undifferentiated Respiratory Infections in Infants
Authors: Ackerman Bruce D. 
Published: November 2007

In this double-blind study of 60 infants with undifferentiated respiratory diseases, antibiotics seemed of no benefit in shorten ing the median duration of illness or in preventing secondary complications. The conclusion is drawn that the danger of complications from the antibiotics them selves is greater than the good which many physicians believe that antibiotics produce in such diseases.
The Influence of Protein-Calorie Malnutrition on the Pattern of Pre-School Childhood Diseases
Authors: Ogbeide M.I. 
Published: November 2007

Lagos, the Capital Territory of Nigeria, has an estimated 300,000 children under 15 years of age. With a total of only 140 hos pital beds available in two Pediatric Centers, the in-patient turnover is tremendous, and the size of the out-patient load unbelievable. This account of pediatric observations in Nigeria, with its new and somewhat un orthodox conclusions, has great pertinence to Western Hemisphere problems of the re lationships between poverty and childhood diseases.
Clinical Review : Renal Tubular Acidosis: Practical Guides to Diagnosis and Treatment
Authors: Hirschman Gladys H. , Rao David D. , Oyemade Olusola , Chan James C. M. 
Published: November 2007

The syndrome of renal tubular acidosis in some one of its various forms should be suspected when an infant or child has failure to thrive, metabolic acidosis, constipation, diarrhea, vomiting, anorexia, polyuria, or dehydra tion in infancy. Confirmatory biochemical findings include an inappropriately high urinary pH, inadequate acid excretion and/or abnormal tubular reab sorption of filtered bicarbonate. Growth can be normal when there is sustained correction of the metabolic acidosis through appropriate alkaline therapy.
Congenital Stridor in Infancy
Authors: Kahn A. , Baran D. , Spehl M. , Dab I. , Blum D. 
Published: November 2007

Thirty-one cases of persistent stridor during infancy, which on study proved to be of congenital origin, were analyzed. The breakdown of these cases is as follows: 4 laryngotracheomalacia, 3 vascular anomalies, 4 angiomas, 1 mucous membrane, 1 laryngeal cyst. The remaining cases (18) belong to the so-called "benign" stridor group in that no specific etiology could be demonstrated and in that evolution was spontaneously favorable. In every case of stridor, the precise underlying cause should be looked for. In addition to clinical assessment the investigation of an infant with stridor calls for the following methods of examination: chest x-ray; larynx x-ray (anterior and lateral view) during inspiration and expiration; esophago gram; direct and laryngotracheoscopy. Angiopneumography should be confined to specific cases.
Long-term Follow-up of Ambulatory Management of Osteomyelitis
Authors: Dunkle Lisa M. , Brock Norma 
Published: November 2007

Over four years, 50 patients with osteomyelitis (32 classified as acute and 18 as subacute or chronic disease) were treated with oral antibiotics in an ambulatory setting. The profile of clinical and laboratory parameters, including etiologic agents, was similar to previous series. Forty-eight patients initially received parenteral drugs, mean duration 14 days (range 0-36). Oral agents administered at home included cephalosporins, clindamycin, dicloxacillin, peni cillin VK, amoxicillin, and sulfa-trimethoprim. Mean duration of total therapy was 53.2 days (range 16-365). In follow-up, ranging from 12 to 60 months (mean 35), relapses occurred in one patient with acute and one with chronic disease. Both responded to oral treatment. No residual infection has resulted, although clinical and radiographic sequelae remain in six more patients initially termed subacute or chronic. Long-term follow-up of patients receiving high-dose oral antibiotic therapy for osteomyelitis due to sensitive organisms confirms the safety and efficacy of this mode of treatment and the feasibility of ambulatory management. The outcome after oral therapy is equivalent to that following parenteral therapy. Patients with subacute or chronic disease have a significantly poorer prognosis despite a milder initial illness and longer course of therapy.
Significance of Neutrophils in Cerebrospinal Fluid Samples Processed by Cytocentrifugation
Authors: Naqvi Shehla H. , Dunkle Lisa M. , Naseer Shahida , Barth Charles 
Published: November 2007

We reviewed medical records of 155 pediatric patients whose cerebrospinal fluid (CSF) sam ples contained an increased proportion of neutrophils when processed by cytocentrifugation, despite normal CSF total white blood cell count. It was determined that these CSF findings occurred more commonly in patients with bacteremia, peripheral leukocytosis, and increased numbers of red blood cells in the CSF. Pulmonary infiltrates in infants and otitis media in children were also significantly associated. Cytocentrifugation allows the identification of neutrophils in the CSF, even in the absence of central nervous system infection. Infants and children with more than 10 per cent neutrophils in CSF require evaluations for focal and bacteremic infections.
House Officer Management of the Febrile Child
Authors: Weiss Jeffrey , Herskowitz Lee 
Published: November 2007

Questionnaires were used to survey 95 pediatric house officers in order to determine their reasons and methods for treating fever, as well as their knowledge of fever physiology. The reasons given for treating fever were to make the child comfortable (99%), to prevent seizures (63%), and to satisfy parents (44%). The average temperature at which antipyretic medication was started was 38.6 ± 0.3 C. Alternating doses of aspirin and acetaminophen were used by 53 per cent, and sponging was recommended by 76 per cent of the residents. The average tem perature at which sponging was started was 39.5 ± 0.6 C. The percentage of house officers who use sponging and/or alternating doses of antipyretics differed greatly from hospital to hospital. Sixty-one per cent of the residents felt that fever is a defense mechanism which does not require treatment. Despite this belief, the majority of these residents use vigorous means to lower fever in children.
Use of an Anaerobic Culture Jar in Processing Pediatric Throat Cultures
Authors: Hayden Gregory F. , Dudley Sharon , Hendley J. Owen 
Published: November 2007

Two hundred consecutive throat cultures from a Pediatric Walk-in Clinic were processed, using both aerobic and anaerobic culture techniques. The 35 aerobic isolates of group A beta-hemolytic streptococci (BHS) were all confirmed anaerobically as well, and there were two additional isolates detected only by the anaerobic technique. Of these 37 bacitracin-sensitive isolates, only 24 (65%) could be identified at 24 hours using the aerobic technique, compared to 29 (78%) using the anaerobic technique. In contrast to this relatively small effect upon the isolation of group A BHS, the yield of BHS from groups B, C, F, and G was more than doubled by the anaerobic technique. The confusion engendered by the improved detection of these bacitracin-resistant BHS using the anaerobic tech nique offset the small advantage in thoroughness and speed of detection of group A organisms. On this account, until more is known about the possible signaficance of isolating nongroup A BHS in the pharynx, the advisability of using an anaerobic culture jar to process pediatric throat cultures remains uncertain.
Idiopathic Torsion Dystonia Associated with Lesions of the Basal Ganglia
Authors: PeBenito Rhandy , Farretti Chantal , Chaudary Riffat R. , Woodrow Paul K. 
Published: November 2007

We report two siblings who are suffering from a dystonic syndrome, clinically indistinguishable from idiopathic torsion dystonia (dystonia musculorum defor mans) but with cranial computerized tomographic scan findings of basal ganglia lesions, similar to that reported in Wilson's disease. The occurrence of the disorder in the same sibship suggests an autosomal recessive mode of inheritance and may represent another variety of the syndrome of idiopathic torsion dystonia.
Serum Immunoglobulins in the First Year of Life
Authors: Fosarelli Patricia , Winkelstein Jerry , DeAngelis Catherine , Mellits E. David 
Published: November 2007

Serum IgG, IgM, and IgA were measured in 316 infants younger than 12 months of age. Information including the child's race, sex, age, and past history of infections or atopy was collected. Birth records were also reviewed to ascertain the child's birthweight and gesta tional age. Serum IgG levels were higher in black infants than in white infants after the age of 4 months. Serum IgM levels were higher in black females than in black males for infants older than 1 month. For infants younger than 4 months of age, those weighing less than 2500 g at birth had lower IgG levels than those weighing more than 2500 g. Infants younger than 1 month whose gestational age had been less than 36 weeks had lower IgG levels than those greater than 36 weeks. Infants aged 1 to 4 months whose gestational age had been less than 36 weeks had lower IgG levels than did those 40 or more weeks. Infants with a positive history for atopy had lower IgG levels than similarly aged infants with a negative history.
Ultrasonic Systolic Blood Pressure Gradient Between Upper and Lower Limbs in Normal Term Chinese Neonates
Authors: Ho T.F. , Yip W.C.L. , Tay J.S.H. , Wong H.B. 
Published: November 2007

The determination of a normal pattern of systolic blood pressure (SBP) gradient between upper limbs (UL) and lower limbs (LL) in neonates is important in the diagnosis of the coarctation syndrome. The scarcity of studies of normal neonates and the conflict of opinion prompted us to evaluate this problem. The UL and LL systolic blood pressures of 100 normal term Chinese neonates were measured by the Doppler Ultrasonic method (Roche Arterio sonde 1020). Under resting condition, the majority (89%) of our neonates had a negative SBP gradient (LL > UL). The mean LL SBP (70.1 mmHg) was significantly higher than that of the UL (59.5 mmHg), p < 0.001. Eleven out of 100 of our neonates had a positive (UL > LL) SBP gradient. Eight of these were less than 1 week old. None had a positive gradient of more than 20 mmHg. According to the results of our study, during the first week of life, normal neonates may have upper limb pressure greater than lower limb of up to 20 mmHg.
Children Less Than Three-Years-Old With Pharyngitis
Authors: Schwartz Richard H. , Hayden Gregory F. , Wientzen Raoul 
Published: November 2007

During a 15-month period, 148 infants and children less than 3-years-old who presented with signs and/or symptoms of pharyngitis were monitored in a private pediatric practice. Clinical signs included fever (95 or 64%), tonsillar exudate (16 or 11%), and cervical adenopathy (5 or 3%). Beta-hemolytic streptococci (BHS) from group A were isolated from throat swabs in 37 (25%) instances. These isolations were more common among children 25-35 months old than among children less than 2 years old (35% vs. 19%, p < 0.05), and were significantly more likely when overnight anaerobic culture techniques were used rather than conventional aerobic methods (23 % vs. 11%, p < 0.01). Group A BHS may be isolated relatively frequently from symptomatic children under 3-years-old. Whether these isolations reflect invasive infection or asymptomatic carriage is uncertain.
Combined Iron Deficiency and Lead Poisoning in Children
Authors: Carraccio Carol L. , Bergman Garrett E. , Daley Barbara P. 
Published: November 2007

Concern for the concomitant occurrence of iron deficiency and elevated blood lead in children is raised by animal studies documenting increased gastrointestinal lead absorption in the presence of iron deficiency. An elevation in free erythrocyte protoporphyrin (FEP) above 35 mg/dl is seen with both iron deficiency and lead toxicity. To determine whether the degree of elevation in FEP is useful in predicting which children with elevated blood lead levels have concomitant iron deficiency, 109 children suspected of having an elevated lead burden were studied. A complete blood count, reticulocyte count, FEP, lead, and ferritin were measured on each child. The effect of the independent variables, lead and iron status, both alone and in combination, on the dependent variable, FEP, was analyzed through a linear regression model. Lead status alone accounted for 42 percent of the explained variance in FEP, and the lead-iron interaction increased the explained variance by only an additional 1 percent. Screening for iron deficiency in children with elevated blood lead should continue to be based on dietary and socioeconomic risk factors and not on degree of elevation in FEP.
Use of the Haemophilus influenzae Type b Vaccine Among Preschool Attendees
Authors: Gilsdorf Janet R. 
Published: November 2007

Use of the Hib vaccine during the first 15 months after licensure was studied in a university-based preschool program. Questionnaires were sent to the parents of the 176 children, ages 29-82 months, enrolled; 115 questionnaires (65.3%) were returned. Fifty seven children (49.6%) had received the Hib vaccine; the mean age at immunization was 40.6 months (range, 22-70 months). Of the 17 children who were under age 24 months at the time of vaccine licensure (April 1985), 14 (82%) were ultimately immunized. One child (age 22 months) received the vaccine before age 24 months. At 15 months after licensure, 80 percent of the 2-year-old children were immunized; 78 percent of 3 year olds; 55 percent of 4 year olds; 15 percent of 5 year olds; and 17 percent of 6 year olds. Thus, although the vaccine was underused as defined by the current recommendations for this group of children, the majority of children at greatest risk for disease—those under age 4 years—were immunized.
Athletic Overuse Injuries in Children
Authors: Kannus Pekka , Niittymäki Seppo , Järvinen Markku 
Published: November 2007

A 30-month prospective follow-up study of children's overuse injuries at an outpatient sports clinic was carried out to determine the number, profile, and specific features of these injuries compared with those of young adults. During this period 74 athletically active boys (≤15 years), 83 girls, 255 men (21-30 years), and 77 women visited the station because of an overuse sports injury of the musculoskeletal system. About one-third of the patients of each group did not seek medical help until more than 6 months after the onset of the symptoms. The injuries most commonly affected the lower extremities, with the knee joint involved in about one third of patients. In girls and women, the lower back (13%) was significantly more frequently affected than in boys and men (6%) (p < 0.01). Thirty two percent of all boys' overuse problems were classified as exercise-induced growth disorders and osteochondritic pains (apophysitides, etc.), but in girls only 13% had a similar basis. The most common diagnosis among boys was Osgood-Schlatter's disease (13 patients, 18%); in girls it was nonspecific synovitis of the knee (9, 16%).
Aldosterone-producing Adenoma Presenting with Hypokalemic Myopathy
Authors: Dickson Bryan A. , Franks Robert C. 
Published: November 2007

A 9-year-old boy who complained of fatigue, myalgias, and progressive weakness was found to have a markedly elevated serum creatine phosphokinase (CPK). He developed polyuria with polydipsia and was noted to be hypertensive and severely hypokalemic. Treatment with potassium and spironolactone alleviated his signs and symptoms and normalized the blood pressure and CPK. Initial studies revealed low plasma renin activity that did not increase with change from supine to upright position. Plasma aldosterone was consistently elevated in the supine position, decreased with upright posture, and was not suppressed by administration of dexamethasone. Plasma 18-hydroxycorticosterone also was elevated. Enhanced computerized tomography (CT) revealed a mass in the left adrenal that had not been seen on the initial unenhanced scan. Adrenal vein catheterization confirmed elevated plasma aldosterone on that side. Adrenalectomy was performed, and a well-encapsulated adenoma was found at examination of the surgical speciman. Postoperatively, suppression of plasma renin activity continued for many months without signs of aldosterone deficiency.
Intracranial Tuberculoma
Authors: Bagga A. , Kalra V. , Ghai O.P. 
Published: November 2007

We used computerized tomography (CT) to screen 83 patients with partial seizures who had 1) increased intracranial pressure; 2) evidence of systemic tuberculosis; or 3) focal neurological deficit. We found intracranial tuberculoma in 20 (24%). In addition, of 55 patients with tuberculous meningitis, 12 had associated tuberculoma. The image morphology on CT scans showed ring lesions (14), discs (10), and irregular coalescing masses (8). Perilesional edema frequently was present. After appropriate antitubercular therapy, clinical outcome for seizures, neurological deficit, and increased intracranial pressure was satisfactory. CT lesions regressed within 12 weeks of inauguration of medical therapy in most patients. Medical management of tuberculoma is advocated, with surgery limited to those in whom such treatment is ineffective.
Infectious Episodes Following Diphtheria-Pertussis-Tetanus Vaccination
Authors: Jaber Lutfi , Shohat Mordechai , Mimouni Marc 
Published: November 2007

Eighty two infants, aged 2-12 months, were prospectively studied for infectious episodes following diphtheria-pertussis-tetanus (DPT) immunization. The occurrence of infectious episodes during the month following vaccination was compared to that during the month prior to its administration. The 3 days following vaccination were not included. In comparison to the month prior to immunization, during the month following there were significantly more infants with fever (6.1% vs. 24.4%, p < 0.001), with diarrhea (7.3% vs. 23.1%, p < 0.005), and with cough (37.7% vs. 52.4% p N.S.). After the first month of the study, there was an increase in morbidity in the region, so we reevaluated those cases who had been seen during the latter 3 months. The same trend was found: in the month following immunization there were significantly more infants with fever (5.3% vs. 25%, p < 0.005), with diarrhea (10.5% vs. 28%, p < 0.02), and with cough (26% vs. 54%, p < 0.01). There was no correlation between the incidence of these episodes and the age at vaccination. In addition to reactive fever during the first 3 days following DPT immunization, an increase in infectious episodes seems to occur in infants during the month following administration of this vaccine.