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Adolescent acquired immunodeficiency syndrome. A paradigm for training in early intervention and care. 青少年获得性免疫缺陷综合征。早期干预和护理培训的范例。
American journal of diseases of children Pub Date : 1990-01-01 DOI: 10.1001/ARCHPEDI.1990.02150250052030
K. Hein
{"title":"Adolescent acquired immunodeficiency syndrome. A paradigm for training in early intervention and care.","authors":"K. Hein","doi":"10.1001/ARCHPEDI.1990.02150250052030","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1990.02150250052030","url":null,"abstract":"The human immunodeficiency virus (HIV) epidemic may portend disaster or may become an opportunity for learning some of the basic lessons of medicine for those entering the ranks of health care workers in the 1990s. At present, a small cadre of health care professionals have dedicated themselves exclusively to the care of HIV-infected people. Although their number has increased in the past 8 years, they still represent a tiny fraction of total health care professionals. As they age or burn out, who will be there to take their places? 1 Major academic medical centers on the East and West coasts have not filled residency training slots with the candidates of their choice for the past several years. One of the reasons given by candidates and feared by training directors is the acquired immunodeficiency syndrome (AIDS) epidemic. The muchpublicized strain on existing resources, the emotional drain caused by caring for terminally","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"36 1","pages":"46-8"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85231790","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}
引用次数: 6
Is standard practice 'standard' in community pediatrics? 社区儿科的标准做法是“标准”吗?
American journal of diseases of children Pub Date : 1990-01-01 DOI: 10.1001/ARCHPEDI.1990.02150250013002
R. A. Jessee
{"title":"Is standard practice 'standard' in community pediatrics?","authors":"R. A. Jessee","doi":"10.1001/ARCHPEDI.1990.02150250013002","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1990.02150250013002","url":null,"abstract":"Sir .—I consider my medical training to have been divided into three parts. The first period was the education and experience I received before medical school and residency (BMSR), the second was during medical school and residency (DMSR), and the last was after medical school and residency (AMSR). Each period provided a unique perspective, but was not complete in itself. My medical training experience was a sheltered world where an aversion to the acute embarrassment of having the chief resident point out a flaw in my workup resulted in a compulsion to order extensive and generally uninformative batteries of tests for even the simplest of problems. It took 2 years after leaving my residency program for me to decompress from this environmentally induced paranoia. Of course it did not surprise me that 65% of AMSR pediatricians would not order roentgenography on an asymptomatic child who had swallowed a coin. The","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"60 1","pages":"11-4"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88550597","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}
引用次数: 2
Radiological case of the month. Monostotic fibrous dysplasia of the temporal bone. 本月放射学病例。颞骨单一纤维发育不良。
American journal of diseases of children Pub Date : 1989-11-01 DOI: 10.1001/ARCHPEDI.1989.02150230109036
Y. Talmi, J. B. Ziv, R. Shimberg, Y. Finkelstein, Y. Zohar, B. Wood
{"title":"Radiological case of the month. Monostotic fibrous dysplasia of the temporal bone.","authors":"Y. Talmi, J. B. Ziv, R. Shimberg, Y. Finkelstein, Y. Zohar, B. Wood","doi":"10.1001/ARCHPEDI.1989.02150230109036","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150230109036","url":null,"abstract":"Computed tomographic scan demonstrating narrowing of the left external auditory canal caused by an expansile bone lesion of the temporal bone (curved arrow). The regional bone was characterized by a \"ground-glass\" appearance. A small cholesteatoma is located between the tympanic membrane and the bony lesion (black arrow).","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"9 1","pages":"1351-2"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75313756","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}
引用次数: 0
Serum phosphate concentration. Effect on serum ionized calcium concentration in vitro. 血清磷酸盐浓度。对离体血清离子钙浓度的影响。
American journal of diseases of children Pub Date : 1989-11-01 DOI: 10.1001/ARCHPEDI.1989.02150230098031
M. Lehmann, F. Mimouni
{"title":"Serum phosphate concentration. Effect on serum ionized calcium concentration in vitro.","authors":"M. Lehmann, F. Mimouni","doi":"10.1001/ARCHPEDI.1989.02150230098031","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150230098031","url":null,"abstract":"We examined the effects of variations of serum phosphate levels on serum ionized calcium concentrations in vitro. A single donor serum sample was divided into 25 aliquots stored in tubes sealed with carbon dioxide and divided into 5 subsets of tubes. The pH was altered in 4 of the 5 subsets by adding various concentrations of hydrochloric acid or sodium hydroxide. The pH levels studied ranged from 7.09 to 7.63. The phosphate concentration was altered in each subset by adding various concentrations of a phosphate buffer. The phosphate concentrations studied ranged between 0.81 and 3.58 mmol/L. There was an inverse relationship between ionized calcium and phosphate at all pH levels studied. The ionized calcium concentration correlated inversely with pH. We suggest that in addition to factors well known to influence serum ionized calcium concentration (such as protein, bicarbonate, and pH values), serum phosphate concentration also plays an important role.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"37 1","pages":"1340-1"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90281129","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}
引用次数: 14
Circumcision and urinary tract abnormalities. 包皮环切术和尿道异常。
American journal of diseases of children Pub Date : 1989-11-01 DOI: 10.1001/ARCHPEDI.1989.02150230020010
L. Hopp
{"title":"Circumcision and urinary tract abnormalities.","authors":"L. Hopp","doi":"10.1001/ARCHPEDI.1989.02150230020010","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150230020010","url":null,"abstract":"Sir .—In the March 1989 issue of AJDC , Herzog 1 presented reports of 36 infants with positive urine culture during routine workup for acute illness. All these infants were uncircumcised, whereas this was true only for 32% of the control population. Of the 31 infants who underwent roentgenographic studies, 4 had grade II and 2 grade IV reflux, 1 had posterior urethral valve with hydronephrosis, and 1 had ureteropelvic junction obstruction and hydronephrosis. The authors concluded that noncircumcision is a highly significant risk factor for UTI in infants. There is a recent surge of interest and controversy about the association of infantile UTI and periurethral bacterial flora with noncircumcision. 2-14 On one side of the spectrum circumcision is considered to be a prophylactic measure against UTI in infants (Wiswell and his collaborators 3,8,10,13,14 ), while on the other, the need to perform surgery on 96 to 98 infants to prevent two to","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"3 1","pages":"1261-2"},"PeriodicalIF":0.0,"publicationDate":"1989-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77097213","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}
引用次数: 3
Reye's syndrome. A reappraisal of diagnosis in 49 presumptive cases. 雷氏症候群。49例推定病例诊断的重新评估。
American journal of diseases of children Pub Date : 1989-10-01 DOI: 10.1001/ARCHPEDI.1989.02150220079023
M. Gauthier, J. Guay, J. Lacroix, A. Lortie
{"title":"Reye's syndrome. A reappraisal of diagnosis in 49 presumptive cases.","authors":"M. Gauthier, J. Guay, J. Lacroix, A. Lortie","doi":"10.1001/ARCHPEDI.1989.02150220079023","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150220079023","url":null,"abstract":"We retrospectively studied 49 patients who were discharged from Sainte-Justine Hospital, Montreal, Canada, or who died between 1970 and 1987 with a presumptive diagnosis of Reye's syndrome. Reye's syndrome was defined as certain, probable, unlikely, or excluded according to clinical, biological, and histologic criteria agreed on a priori by a panel of experts. Patient charts were reviewed blindly by three clinicians. Assessments were similar in 42 cases (86%) (weighted K = 0.78 to 0.85, which suggested substantial agreement); for the remainder, agreement was reached after discussion. Reye's syndrome was considered certain in 1 case (2%), probable in 11 (22%), unlikely in 21 (43%), and excluded in 15 (31%). Four children in the study group did not undergo biopsy or autopsy; in three of these, Reye's syndrome was unlikely according to clinical and biological criteria, and in one, the diagnosis was unclassifiable. The incidence of certain or probable Reye's syndrome was low in our institution during the study period. Our results suggest that the apparent disappearance of Reye's syndrome should be reassessed.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"1 1","pages":"1181-5"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76141654","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}
引用次数: 24
Origins of cerebral palsy. 脑瘫的起源。
American journal of diseases of children Pub Date : 1989-10-01 DOI: 10.1097/00132582-199007000-00011
R. Naeye, E. Peters, M. Bartholomew, J. Landis
{"title":"Origins of cerebral palsy.","authors":"R. Naeye, E. Peters, M. Bartholomew, J. Landis","doi":"10.1097/00132582-199007000-00011","DOIUrl":"https://doi.org/10.1097/00132582-199007000-00011","url":null,"abstract":"Analyses were undertaken to determine the causes of cerebral palsy in a prospective study of 43,437 full-term children. Presumed causes were found for about 71% of the 34 quadriplegic and 40% of the 116 nonquadriplegic patients with cerebral palsy. Risk estimates based on predictive models, adjusted for multiple factors, suggest that 53% of the quadriplegic patients with cerebral palsy could be attributed to congenital disorders, 14% to birth asphyxia, and 8% to other identified disorders. Thirty-five percent of the nonquadriplegic patients with cerebral palsy could be attributed to congenital disorders and 6% to other disorders. In the victims of cerebral palsy, characteristic consequences of birth asphyxia were more often the result of nonasphyxial disorders. These included meconium in the amniotic fluid, low 10-minute Apgar scores, neonatal apnea spells, seizures, persisting neurologic abnormalities, and slow head growth after birth.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"10 1","pages":"1154-61"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90120053","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}
引用次数: 89
Parent, teacher, child. A trilateral approach to attention deficit disorder. 家长，老师，孩子。注意缺陷障碍的三边方法。
American journal of diseases of children Pub Date : 1989-10-01 DOI: 10.1001/ARCHPEDI.1989.02150220137034
Melvin L. Cohen, Patrick C. Kelly, A. Atkinson
{"title":"Parent, teacher, child. A trilateral approach to attention deficit disorder.","authors":"Melvin L. Cohen, Patrick C. Kelly, A. Atkinson","doi":"10.1001/ARCHPEDI.1989.02150220137034","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150220137034","url":null,"abstract":"We compared the effectiveness of three instruments in initially diagnosing and monitoring children with attention-deficit disorder with and without hyperactivity (ADD/H). Twenty-one children clinically assessed as having ADD/H and meeting criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, were examined initially and after treatment with methylphenidate hydrochloride and placebo. The following instruments were used: the ADD-H Comprehensive Teacher Rating Scale, the Connors' Parent Rating Scale-Revised, and the Gordon Diagnostic System. The ADD-H Comprehensive Teacher Rating Scale initially classified 67% of the children as having ADD/H and 14% as borderline. The Connors' Parent Rating Scale-Revised identified 71% as having ADD/H, while the Gordon Diagnostic System assessed 52% as having ADD/H and 29% as borderline. With methylphenidate treatment, the mean scores on the ADD-H Comprehensive Teacher Rating Scale displayed an increase in attention span and a decrease in hyperactivity, the Connors' Parent Rating Scale-Revised showed a significant decrease in ADD/H behavior, and the Gordon Diagnostic System mean scores indicated no significant change.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"11 1","pages":"1229-33"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75266089","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}
引用次数: 19
Acquired immunodeficiency syndrome among adolescents. Case surveillance profiles in New York City and the rest of the United States. 青少年获得性免疫缺陷综合征。纽约市和美国其他地区的病例监测概况。
American journal of diseases of children Pub Date : 1989-10-01 DOI: 10.1001/ARCHPEDI.1989.02150220128032
Sten H. Vermund, K. Hein, H. Gayle, Jean M. Cary, P. Thomas, E. Drucker
{"title":"Acquired immunodeficiency syndrome among adolescents. Case surveillance profiles in New York City and the rest of the United States.","authors":"Sten H. Vermund, K. Hein, H. Gayle, Jean M. Cary, P. Thomas, E. Drucker","doi":"10.1001/ARCHPEDI.1989.02150220128032","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150220128032","url":null,"abstract":"Adolescents engaging in certain sexual or drug-related behavior are at risk of contracting the human immunodeficiency virus infection in endemic locales. Local and national surveillance data were analyzed to determine the characteristics of the acquired immunodeficiency syndrome (AIDS) epidemic on adolescents. Of the 605 cases of AIDS in people aged 13 to 21 years reported through 1987, 518 were males (83 from New York City [NYC], NY), and 87 were females (28 from NYC). Over half of all adolescent males with AIDS reported homosexual contact. Transfusion/blood product-related human immunodeficiency virus acquisitions (especially in males with hemophilia) represented 11% of adolescent cases from NYC (1% of NYC adults) and 22% of adolescent cases in the United States (US) outside of NYC (4% of adults in the US). Intravenous drug use was more frequently reported among adolescents with AIDS from NYC (23%) than among adolescents outside NYC (14%). In females, heterosexual transmission accounts for about half of all adolescent AIDS cases and 29% of all adult cases. Age-appropriate services and behavioral interventions are urgently needed for high-risk adolescents.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"37 1","pages":"1220-5"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76298013","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}
引用次数: 51
Acute suppurative adenoiditis. 急性化脓性腺样体炎。
American journal of diseases of children Pub Date : 1989-09-01 DOI: 10.1001/ARCHPEDI.1989.02150210014005
M. R. Weir, N. Duncan
{"title":"Acute suppurative adenoiditis.","authors":"M. R. Weir, N. Duncan","doi":"10.1001/ARCHPEDI.1989.02150210014005","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150210014005","url":null,"abstract":"Sir.—A case of isolated adenoiditis prompted a search of the literature for the condition. The results of the search were startling due to the virtual absence of characterization of what should be a distinctive, and not unusual, clinical entity. Patient Report.—A previously healthy 9-year-old girl presented with fever, rhinorrhea, pharyngeal pain, and hyponasal speech of 2 days' duration. She reportedly had had a tonsillectomy and adenoidectomy 3 years earlier for recurrent adenotonsillitis. Abnormalities on physical examination were limited to fever (temperature, 40°C), serous rhinorrhea that prompted nearly constant sniffling, total occlusion of the posterior nasal airway, and an exudative fullness just visible in the superior pharynx behind the uvula. Mild posterior cervical adenopathy was also present. A lateral soft-tissue roentgenogram of the head and neck was obtained (Figure). The postero-superior location and contour of the naso-pharyngeal mass seen on the roentgenogram suggested adenoid hypertrophy. Flexible fiberoptic nasopharyngoscopy revealed","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"2005 1","pages":"998"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89522689","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}
引用次数: 19
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