ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

During the last decade, a number of technological innovations in disposable diaper designs and materials have aimed at reducing dermatological problems in the diaper area. The introduction of absorbent gelling materials led to a decrease in skin overhydration and made possible a more beneficial pH in the diaper area. A retrospective evaluation of clinical studies conducted before and after the introduction of absorbent gelling materials confirms that utilization of these materials has been associated with a marked reduction in the severity of diaper dermatitis. More recently, a novel diaper designed to deliver dermatological formulations to the skin also appears to improve the condition of diapered skin. Disposable wipes now are available that are nonirritating and suitable for use on damaged or broken skin. Ongoing innovative efforts in this area promise to further decrease the prevalence of diaper-associated dermatologic conditions.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The field of pediatric dermatology continues to be enriched by the insights offered through molecular genetics. For some genetic skin disorders, including neurofibromatosis, tuberous sclerosis complex, and several forms of epidermolysis bullosa, genetic research has resulted in an evolving understanding of the relationship between genotype and phenotype, with the ability to predict some of the features of these disorders on the basis of the genetic defect. However, widespread use of molecular genetics for diagnostic testing of these disorders has not been possible because of genetic heterogeneity, limited availability, and reduced sensitivity. The appropriate use of genetic services is emphasized in this, the molecular era.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Pigmentary disorders are a common finding in primary care pediatric practice. Tuberous sclerosis and neurofibromatosis type 1 are two pigmentary disorders that have had many changes in their diagnostic and therapeutic approach. This review focuses on the significant advances in the past few years in the genetics and diagnostic criteria of these disorders. A review of the clinical presentation of neurofibromatosis is provided along with the revised diagnostic criteria for tuberous sclerosis. A logical approach to testing the tuberous sclerosis patient and his or her family is included.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Viral exanthems are common in childhood and account for a large number of patient visits to pediatric or family medicine clinics. Most exanthems are virtually harmless to the healthy child, but others can be signs of more significant systemic disease. Some exanthems that are benign or self-limited in the healthy child may propose significant risk to pregnant or immunocompromised individuals. Therefore, recognition of exanthems, which may be associated with certain viral illnesses, is important for the primary care provider. For example, prompt recognition of a viral exanthem caused by parvovirus may allow a pregnant female from exposing her fetus to a potentially fatal infection, or, if the exposure has already occurred, may indicate the need for appropriate fetal monitoring. In this manuscript, we review the recent literature pertaining to four characteristic exanthems that are thought to be viral in nature: papular purpuric gloves and socks syndrome; pityriasis rosea; unilateral lateral thoracic exanthem; and Gianotti-Crosti syndrome.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Warts continue to be a therapeutic challenge, especially widespread warts on children. A single, most effective treatment has not been defined. Conventional methods attempt to non-specifically destroy infected tissue. Most of these procedures are painful, poorly tolerated by children, and often require multiple treatments. The efficacy of destructive techniques is impossible to verify in controlled clinical trials. Uncontrolled success rates are suboptimal and often no better than that seen with placebos. Alternative pharmacologic approaches have been designed to stimulate immunologic responses or provide anti-viral activity. Further study is needed to establish efficacy of these treatments.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Advances related to thyrotropin during 1999 included better understanding of the genetic basis of pituitary development and genetic advances in identifying clinical entities and their mechanisms and enabling new therapies. Initial clinical use of recombinant thyrotropin in evaluation of thyroid cancer recurrence was described. The importance of glycosylation pattern was clarified including the role of thyrotropin-releasing hormone in synthesis of thyrotropin molecules with mature glycosylation, and the impact of abnormal glycosylation in loss-of-function and gain-of-function mutations of the thyrotropin receptor. Causes of excessive thyrotropin secretion were evaluated, including pituitary thyrotropin-secreting adenomas. The fairly common causes of central hypothyroidism including ischemic injury, cranial irradiation, psychiatric conditions, or medical illness were assessed. The action of thyrotropin at the thyroid cell was assessed as a growth factor and as an influence on tyrosine sulfate content of thyroglobulin. Such basic and clinical science advances are rapidly affecting clinical care.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Ergogenic aids are taken to enhance energy utilization by producing more, controlling its use, or increasing mechanical efficiency. Most athletes are looking toward enhancing performance by proper training modalities and methods; however, some look to the biochemical route for a “quick fix.” Thus, the use of chemical agents is on the rise. Herein is provided information on the anabolic-androgenic agents androstenedione, dehydroepiandrosterone, and the “parent” compound, testosterone. The former two, at best, have equivocal activity, but testosterone is both anabolic and androgenic in doses that adolescents might receive. Growth hormone and insulin-like growth factor-1 are anabolic, nonandrogenic compounds with undoubted effects on the lean body mass compartment. Both are expensive, not readily available, and subject to the art of counterfeiting. Thus, very few data are available in non-growth hormone-deficient adolescents. The discussion of these agents ends with issues of fairness, ethics, and the message we attempt to project to our teenagers, whether athletes or not.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Maturity onset diabetes of youth (MODY) occurs in children, adolescents and young adults as a non–insulin-requiring form of diabetes mellitus that is inherited as an autosomal dominant trait. Maturity onset diabetes of youth in whites presents subtly similar to type 2 diabetes in adults. In contrast, a MODY variant that occurs in young blacks, termed atypical diabetes mellitus, presents as an acute-onset form of diabetes. Months to years after diagnosis, atypical diabetes mellitus reverts to a noninsulin requiring course similar to MODY in whites. Five molecular causes for MODY have been identified: mutations in four transcription factors and mutations in one enzyme (glucokinase). Transcription factors regulate gene expression within cells. Mutations in hepatocyte nuclear factor-4&agr;, hepatocyte nuclear factor-1&agr;, insulin promoter factor-1 and hepatocyte nuclear factor-1β, respectively, cause MODY1, MODY3, MODY4, and MODY5. Glucokinase is the glucosensor of the β cell. MODY2 is caused by glucokinase mutations. Although testing for MODY mutations is only available in research laboratories, a careful history and review of the patient’s clinical course can often allow the clinician to diagnose MODY. The diagnosis of MODY has implications for the clinical management of the patient’s diabetes.

ISSN:1040-8703    

出版商:OVID    

年代:2000

数据来源: OVID