Pediatric streptococcal toxic shock syndrome.

Two children who presented with fever, rash, and hypotension were found to have group A beta hemolytic streptococcal toxic shock syndrome. These cases are reported to remind physicians who care for acutely ill children that exotoxin-producing streptococci can produce clinical features and multisystem failure similar to staphylococcal toxic shock syndrome.

Implementing critical health services for children in foster care.

This article reports recommendations that were developed at the California Conference on Health Care for Children in Foster Care, organized to discuss implementation in the state of CWLA's Standards for Health Care Services for Children in Out-of-Home Care. Programs and legislation developed in the state are also discussed.

Treatment of hemophilia A with a highly purified factor VIII concentrate prepared by anti-FVIIIc immunoaffinity chromatography.

To reduce the risk of pathogenic virus transmission associated with the therapeutic administration of plasma-derived anti-hemophilic factor (FVIIIc), a process utilizing anti-FVIIIc immunoaffinity chromatography to isolate FVIIIc has been developed. In addition, the starting cryoprecipitate solution has been treated with an organic solvent/detergent mixture to inactivate lipid-enveloped viruses. A final ion exchange chromatography step is used to further remove contaminants, e.

An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.

The management of children who present to the ED with plantar puncture wounds is dependent upon the nature of the injury, the examination of the puncture site, and the potential risk of a retained foreign body. Not all patients will require wound enlargement and a search for a retained foreign body. Close follow-up of all children who are being treated as outpatients is of vital importance in detecting an early development of an infectious complication.

The perversion of mothering: Munchausen syndrome by proxy.

Munchausen syndrome by proxy, in which a seemingly caring and concerned mother is simultaneously harming her child, can best be understood in terms of the mother's need for a relationship with a physician that is rooted in a profound sense of early abandonment. This understanding broadens the definition of perversions. The infant in this sadomasochistic interaction is dehumanized and is used as a fetishistic object to control the relationship.

An approach to pediatric trauma. Unique anatomic and pathophysiologic aspects of the pediatric patient.

Effective evaluation and management of the pediatric trauma patient is based on knowledge of the unique anatomic and pathophysiologic differences in children. An understanding of these differences along with the trauma resuscitation guidelines established by the American College of Surgeons will allow the trauma team to provide systematic and comprehensive resuscitation of the child with multiple injuries. Continued research in the field of pediatric trauma resuscitation and the ongoing efforts of the National Pediatric Trauma Registry will continue to advance our understanding and management of injured children.

Attenuation of mammary duct development by menhaden oil in BALB/c mice.

The predominant polyunsaturated fatty acids of the n-6 family found in corn oil (CO) are crucial for normal mammary duct formation when fed to animals. However, as shown here, not all polyunsaturated fatty acids are equally effective in stimulating mammary gland development. The n-3 fatty acids in a 10% menhaden oil (MO) diet fed to mice effectively reduced both the diameter and the length of the growing mammary ducts.

Language development from six to twelve.

This article has shown that the elementary school years are vital for the growth of linguistic skills. During this period children go from a relatively rudimentary understanding of syntax and grammar to a very sophisticated appreciation of the complexities of language. Syntactic skills also are increasing during these years, particularly the ability to understand factitive verbs and complicated prepositions and conjunctions.

A national survey of the assessment and treatment of pain and agitation in the neonatal intensive care unit.

A national survey was conducted to determine beliefs about neonatal pain and agitation, current methods of assessment, and standards for treatment. The results indicated a lack of consistency in both attitudes and practices among neonatal intensive care unit staff with regard to pain assessment and management in neonates. Methods for assessing the presence of pain or evaluating the effectiveness of treatment appeared inadequate for critically ill infants, particularly intubated and paralyzed infants.

Late-onset 21-hydroxylase deficiency: reliable diagnosis by steroid analysis of random urine collections.

The feasibility of performing steroid analysis by capillary gas chromatography on random urine samples for the detection of mild late-onset 21-hydroxylase deficiency was evaluated. Comparisons were made of basal excretions of androgen and 17 alpha-hydroxyprogesterone metabolites with plasma levels (basal and stimulated) of 17 alpha-hydroxyprogesterone and testosterone in six patients with the disorder. The following steroid metabolite excretion ratios were determined for normal controls and affected individuals.