American journal of diseases of children (1960)最新文献

{"title":"Race and infant mortality.","authors":"R L Naeye","doi":"10.1001/archpedi.1993.02160340016003","DOIUrl":"10.1001/archpedi.1993.02160340016003","url":null,"abstract":"","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1030-1"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19203597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolactin-secreting macroadenomas in adolescents. Response to bromocriptine therapy.","authors":"D Tyson,&nbsp;D Reggiardo,&nbsp;C Sklar,&nbsp;R David","doi":"10.1001/archpedi.1993.02160340043011","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340043011","url":null,"abstract":"<p><strong>Objective: </strong>To report five cases of prolactin (PRL)-secreting macroadenomas in adolescents, including their presentations and responses to bromocriptine mesylate treatment.</p><p><strong>Patients: </strong>Five adolescents (three females and two males) aged between 12.5 and 17 years were diagnosed as having PRL-secreting macroadenomas at the pediatric endocrine service at New York University Medical Center between 1987 and 1989. Presenting complaints included visual field deficits, gynecomastia, and amenorrhea, both primary and secondary. All patients demonstrated some feature of hypogonadism or pubertal arrest. Diagnostic criteria included an elevated serum PRL level (mean, 1670 micrograms/L; range, 610 to 3700 micrograms/L) and visualization of a pituitary tumor that measured greater than 1 cm by either a computed tomographic scan or magnetic resonance imaging (mean size, 2.7 cm; range, 1.4 to 4 cm).</p><p><strong>Interventions: </strong>Each patient was treated with bromocriptine mesylate at an oral dose of 7.5 mg/d. The patients continued with that treatment for the duration of the study period.</p><p><strong>Measurements and results: </strong>Anterior pituitary function was evaluated in four of five patients before treatment. All four were growth hormone deficient. Three patients were also gonadotropin deficient. Thyrotropin (thyroid-stimulating hormone) and corticotropin (adrenocorticotropic hormone) deficiencies were demonstrated in three patients who had multiple pituitary deficits. Follow-up testing included serial PRL measurements and radiographic imaging of tumor size. All patients demonstrated a marked decrease in PRL levels, as well as in tumor size (mean shrinkage, 70%). The three patients who initially had visual field deficits showed significant improvement of vision with bromocriptine therapy. Follow-up study of anterior pituitary function showed significant improvement with bromocriptine treatment in three patients.</p><p><strong>Conclusions: </strong>Bromocriptine was quite effective in the shrinkage of PRL-secreting macroadenomas in all our patients. It is a noninvasive treatment that can preserve and restore vision, as well as pituitary function, which is integral to continued growth and sexual maturation of the adolescent. Bromocriptine is preferable to surgery or radiation in the treatment of PRL-secreting macroadenomas in the adolescent.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1057-61"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340043011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19203604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Firearms and adolescent suicide. A community case-control study.","authors":"D A Brent,&nbsp;J A Perper,&nbsp;G Moritz,&nbsp;M Baugher,&nbsp;J Schweers,&nbsp;C Roth","doi":"10.1001/archpedi.1993.02160340052013","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340052013","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between firearms in the home and adolescent suicide.</p><p><strong>Research design: </strong>Matched, case-control.</p><p><strong>Setting: </strong>Population-based community sample.</p><p><strong>Subjects: </strong>Sixty-seven adolescent suicide victims and a demographically matched group of 67 living community controls.</p><p><strong>Selection procedure: </strong>The series of adolescent suicide victims was consecutive, with an overall participation rate of 74% (67/91).</p><p><strong>Measurements and results: </strong>The presence, type (hand-gun vs long-gun), number, and method of storage (locked vs unlocked, loaded vs unloaded) of firearms in the home were compared between the suicide victims and controls. Even after adjusting for differences in rates of psychiatric disorders between suicide victims and controls, the association between suicide and both any gun (odds ratio [OR] = 4.4, 95% confidence interval [CI] = 1.1 to 17.5) and handguns (OR = 9.4, 95% CI = 1.7 to 53.9) in the home were both highly significant. Long-guns in the home were associated with suicide only in rural areas, whereas handguns were more closely associated with suicide in urban areas. Handguns (OR = 12.9, 95% CI = 1.5 to 110.9) and loaded guns (OR = 32.3, 95% CI = 2.5 to 413.4) in the home were particularly significant risk factors for suicide in those with no apparent psychiatric disorder.</p><p><strong>Conclusions: </strong>When pediatricians are faced with a suicidal adolescent, they should insist on the removal of firearms from the home. Pediatricians should also inform parents that the presence of firearms may be associated with adolescent suicide even in the absence of clear psychiatric illness.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1066-71"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340052013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19203605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birth-weight-specific infant mortality risks and leading causes of death. Illinois, 1980-1989.","authors":"C J Alo, H L Howe, M R Nelson","doi":"10.1001/archpedi.1993.02160340071017","DOIUrl":"10.1001/archpedi.1993.02160340071017","url":null,"abstract":"<p><strong>Objective: </strong>To describe birth-weight-specific differences in mortality risks between white and black Illinois infants by age at death and leading cause of death.</p><p><strong>Design: </strong>Population-based birth cohort study.</p><p><strong>Setting: </strong>State of Illinois.</p><p><strong>Patients: </strong>All Illinois infants who were born from 1980 through 1989 and reported to the Illinois Department of Public Health. The death certificates of these infants were matched to corresponding birth certificates using a computerized linkage algorithm.</p><p><strong>Interventions: </strong>None.</p><p><strong>Results: </strong>The high black infant mortality rate is attributable to higher mortality risks in the neonatal period for black, normal birth-weight infants and in the postneonatal period for all black infants, regardless of birth weight.</p><p><strong>Conclusion: </strong>Efforts to narrow the black-white gap in infant mortality and to reduce black mortality should not be limited to reduction of low birth weight and premature birth in black infants but should also include efforts to reduce risk factors associated with mortality among normal birthweight black infants.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1085-9"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19204200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of weight loss by obese children on long-term growth.","authors":"L H Epstein,&nbsp;A Valoski,&nbsp;J McCurley","doi":"10.1001/archpedi.1993.02160340062015","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340062015","url":null,"abstract":"<p><strong>Objective: </strong>To assess height growth over 10 years in children treated for obesity.</p><p><strong>Design: </strong>Longitudinal, prospective follow-up of a series of randomized, controlled weight control trials.</p><p><strong>Setting: </strong>Specialized pediatric weight control clinic.</p><p><strong>Participants: </strong>One hundred fifty-eight 6- to 12-year-old obese children who were followed up for 10 years after treatment.</p><p><strong>Interventions: </strong>Family-based behavioral weight control.</p><p><strong>Measurements/main results: </strong>At entry the height percentiles of the obese children were significantly higher (71.6 percentile) than same-sex parent (52.0 percentile) or midparent (51.5 percentile) height (an estimate of parental contribution to height). After an average growth of 22.7 cm, children were 2.2 cm taller than their same-sex parent and decreased to an average height percentile of 57.8. Multiple regression analysis showed that child sex, age, baseline height and percent overweight, midparent height, and height change of the child from baseline to 5 years accounted for 94% of the variance in growth. Child percent overweight change made no contribution to predicting height change. Comparison between children obese and nonobese at 10 years showed no differences in growth.</p><p><strong>Conclusions: </strong>Moderate energy restriction with dietary guidance by overweight children did not negatively influence long-term growth.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1076-80"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340062015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19203607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical evaluation of the 2-minute orthopedic screening examination.","authors":"J E Gomez,&nbsp;G L Landry,&nbsp;D T Bernhardt","doi":"10.1001/archpedi.1993.02160340095022","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340095022","url":null,"abstract":"<p><strong>Objective: </strong>To determine the sensitivity and specificity of the 2-minute, 12-step, orthopedic screening examination.</p><p><strong>Design: </strong>Prospective, single-blind study.</p><p><strong>Setting: </strong>National Collegiate Athletic Association Division 1 athletics program.</p><p><strong>Participants: </strong>Two hundred fifty-nine male and female varsity athletes.</p><p><strong>Interventions: </strong>The athletes were screened by five primary care physicians who were \"blind\" to each patient's history. The athletes were then evaluated by a team of orthopedic surgeons who had knowledge of each patient's history. Significant injuries were injuries that would limit participation, predispose to injury, or need further evaluation or rehabilitation.</p><p><strong>Main results: </strong>A total of 120 significant injuries were identified by compiling the results of the history and both physical examinations. Of the significant injuries, 91.6% were detected by history alone. Fourteen of the significant injuries were missed by the detailed orthopedic examination, but they were detected by the screening examination. The overall sensitivity of the screening examination compared with the results of all three methods was 50.8%, with a specificity of 97.5%, positive predictive value of 40.9%, and negative predictive value of 98.3%. Almost half of the false-positive screening findings were shoulder asymmetries.</p><p><strong>Conclusions: </strong>Even in mass screenings, the screening orthopedic examination should be used only in conjunction with an orthopedic history. Some modifications may improve the sensitivity of the screening examination.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1109-13"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340095022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19204205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological cases of the month. Accessory tragus.","authors":"P R Cohen,&nbsp;E Gilbert-Barness","doi":"10.1001/archpedi.1993.02160340109026","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340109026","url":null,"abstract":"","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1123-4"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340109026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19204208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caudal duplication syndrome.","authors":"R Dominguez,&nbsp;J Rott,&nbsp;M Castillo,&nbsp;R R Pittaluga,&nbsp;J N Corriere","doi":"10.1001/archpedi.1993.02160340034009","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340034009","url":null,"abstract":"<p><strong>Objective: </strong>To present the clinical and roentgenographic features of caudal duplication syndrome.</p><p><strong>Design: </strong>Retrospective review of the medical records and all available imaging studies.</p><p><strong>Setting: </strong>Two university-affiliated teaching hospitals.</p><p><strong>Participants: </strong>Six children with multiple anomalies and duplications of distal organs derived from the hindgut, neural tube, and adjacent mesoderm.</p><p><strong>Interventions: </strong>None.</p><p><strong>Results: </strong>Spinal anomalies (myelomeningocele in two patients, sacral duplication in three, diplomyelia in two, and hemivertebrae in one) were present in all our patients. Duplications or anomalies of the external genitalia and/or the lower urinary and reproductive structures were also seen in all our patients. Ventral herniation (in one patient), intestinal obstructions (in one patient), and bowel duplications (in two patients) were the most common gastrointestinal abnormalities.</p><p><strong>Conclusions: </strong>We believe that the above constellation of abnormalities resulted from an insult to the caudal cell mass and hindgut at approximately the 23rd through the 25th day of gestation. We propose the term caudal duplication syndrome to describe the association between gastrointestinal, genitourinary, and distal neural tube malformations.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1048-52"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340034009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19203602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deaths at work among children and adolescents.","authors":"K A Dunn,&nbsp;C W Runyan","doi":"10.1001/archpedi.1993.02160340030008","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340030008","url":null,"abstract":"<p><strong>Objective: </strong>To identify and describe all nonmilitary on-the-job injury fatalities in North Carolina among persons younger than 20 years over 10 years, with special attention to potential violations of the Fair Labor Standards Act.</p><p><strong>Design and setting: </strong>Historical, population-based case series, with cases identified by the computerized files of the North Carolina Office of the Chief Medical Examiner.</p><p><strong>Cases: </strong>Persons younger than 20 years who died of injuries received on the job in North Carolina between January 1, 1980, and December 31, 1989.</p><p><strong>Results: </strong>We identified 71 cases. Decedents ranged in age from 11 to 19 years, with 41% aged 17 years or younger. Cases were disproportionately male (90%), white (80%), and injured during June, July, and August (44%). Farm or field was the most frequent place of injury (27%). More than 50% of injuries involved a motorized vehicle, frequently a tractor. Similar to studies in adults, homicide was the leading cause of fatal occupational injury for females. At the time of injury, 86% of workers younger than 18 years were involved in activities that appeared to violate the Fair Labor Standards Act of 1938.</p><p><strong>Conclusions: </strong>This study raises questions about the adequacy of federal child labor policies as minors continue to work under conditions that place them at risk for fatal injuries.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1044-7"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340030008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19203601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are febrile seizures provoked by a rapid rise in temperature?","authors":"A T Berg","doi":"10.1001/archpedi.1993.02160340087020","DOIUrl":"https://doi.org/10.1001/archpedi.1993.02160340087020","url":null,"abstract":"<p><p>Pediatricians are frequently taught that a rapid rise in temperature is responsible for causing a febrile seizure; yet there are no clinical data to support this hypothesis. The few experimental data are based on hyperthermia-induced seizures in animals and are of no clear relevance to naturally occurring fevers and accompanying seizures. Further, the experimental findings are not consistent across studies. By contrast, there is substantial evidence indicating that the height of temperature plays a role in eliciting a febrile seizure. Although febrile seizures are now recognized as benign and, in general, a disorder that should not be treated with chronic anticonvulsant therapy, an understanding of how fevers lead to febrile seizures may be useful for evaluating the appropriateness and efficacy of treatments that involve intermittent therapy given at the time of fever.</p>","PeriodicalId":75474,"journal":{"name":"American journal of diseases of children (1960)","volume":"147 10","pages":"1101-3"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archpedi.1993.02160340087020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19204202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}