Attention Deficit Disorder Children with or without HyperactivityUllmann, Rina K.; Sleator, Esther K.
doi: 10.1177/000992288502401001pmid: 4028613
Each patient with Attention Deficit Disorder (ADD), with or without hyperactivity, is unique in the variety and severity of the handicapping conditions associated with ADD. The use of a well- designed teacher rating scale can provide the clinician with a behavioral prafile of each patient. The importance of knowing the child's specific problems is emphasized by the results of this research, which show that methylphenidate has a major effect in improving attention, is helpful in decreasing activity level, but often has only a minor effect on deficient social skills and oppositional (aggressive) behavior.
Adverse Effects of Meperidine, Promethazine, and Chlorpromazine for Sedation in Pediatric PatientsNahata, Milap C.; Ootz, Michael A.; Krogg, Elizabeth A.
doi: 10.1177/000992288502401002pmid: 4028614
A combination of meperidine (M) 25 mg/ml, promethazine (P) 6.5 mg/ml, and chlorpromazine (C) 6.5 mg/ml is widely used to produce sedation in pediatric patients. A dose of MPC 0.1 ml/kg is recommended for cardiac catheterization, but no specific guidelines for dosing or frequency of monitoring have been established for patients undergoing other types of procedures. The adverse effects of MPC were studied prospectively in 95 patients undergoing various procedures. MPC was given parenterally at a dose of 0.07-0.11 ml/kg. Four patients developed respiratory depression. In these patients, the lowest respiratory rate ranged from 12 to 20 per minute. The lowest pulse rate ranged from 92 to 102 per minute. Three patients had received recommended or lower than recommended doses of MPC. One who received MPC 0.07 ml/kg developed respiratory arrest within 30 minutes; another required naloxone, and all recovered within 10 hours. These cases suggest the need for frequent monitoring and specific dosing guidelines for MPC use in pediatric patients.
Daily Calorie and Fluid Calculations in the Intensive Care Nursery Using a Pocket ComputerYamamoto, Loren G.
doi: 10.1177/000992288502401003pmid: 3928226
A computer program, run on a hand-held printing pocket computer, that simplifies routine calorie and fluid calculations on high-risk neonates in the intensive care nursery is described. It is useful in performing these calculations on patients with parenteral nutrition, diluted feedings, other intravenous fluids, and medium-chain triglyceride oil supplements, all of which make calorie and fluid calculations by hand very difficult. Both physician and nonphysician personnel can be taught to use this program, allowing them to quickly and easily perform the otherwise laborious fluid and calorie calculations, even on complicated patients.
Clinical Presentation and Management of Pseudomonas OsteomyelitisElliott, Stephen J.; Aronoff, Stephen C.
doi: 10.1177/000992288502401004pmid: 3928227
To determine the incidence and clinical characteristics of Pseudomonas aeruginosa osteomyelitis in children, the records of 144 hospitalized patients under 19 years of age were reviewed; 104 fulfilled the study criteria for the diagnosis of acute or chronic osteonxyelitis. Pseudomonasaeruginosa was recovered from 10.6 percent of the children and was the second most common pathogen isolated. In comparison to children with staphylococcal infections, patients with pseudomonal osteomyelitis were significantly older, gave an antecedent history of penetrating trauma, and lacked clinical and laboratory evidence of systemic illness. The data collected in this study suggest that osteomyelitis due to Pseudomonas aeruginosa is a distinct entity with clinical features differing from those of Staphylococcus aureus. Management should be directed at adequate surgical debridement followed by 10 to 21 days of antimicrobial therapy.
Age-specific Patterns of Diagnosis of Acute Otitis MediaMcFadden, D.M.; Berwick, D.M.; Feldstein, M.L.; Marter, S.S.
doi: 10.1177/000992288502401005pmid: 4028615
A retrospective review of clinical experience with the diagnosis of acute otitis media (AOM) in a large pediatric population (age, 0-12 years old) reveals two age-specific patterns of diagnosis: one in preschool children and one in schoolage children. In the population as a whole, AOM is diagnosed most frequently in the first 5 years of life; rates of diagnosis vary with gender (male: female ratio = 1.10) and season (fall/winter peak). In a linear regression model, age, gender, season, and interactions among these account for 52 percent of the variability in diagnostic rates.In children less than 5 years of age, rates of diagnosis vary strikingly with gender and season; the regression model accounts for 55 percent of observed variability in diagnostic rates. In schoolage children (5-11 years old), however, males and females are equally likely to be diagnosed to have AOM, and seasonal variability is blunted; among these children, the regression model predicts only 22 percent of diagnostic rate variability.These findings buttress existing knowledge of the epidemiology of AOM and have important implications for clinical practice, health planning, and pediatric research.
Seven Hereditary Syndromes with Pigmentary RetinopathyCantani, Arnaldo; Bellioni, Paolo; Bamonte, Gabriele; Salvinelli, Fabrizio; Bamonte, Marina Tucci
doi: 10.1177/000992288502401006pmid: 3896611
This article reviews several autosomal recessive syndromes characterized by pigmentary retinopathy and, in many, combined with deafness, hypogonadism, and/or mental retardation. These syndromes are manifested in infancy and childhood. Although no specific treatment is available, an early diagnosis can be the first step in initiating symptomative management and preventive measures for the patient and family.