ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Genetic causes account for 20% to 25% of human birth defects, but the largest proportion of birth defects have no definitive etiology and some of these malformations may be due to intrinsic, “nonpreventable” spontaneous errors of development. Environmental causes, which include maternal disease states, maternal infection, mechanical factors, problems of constraint, chemicals, drugs, and physical agents, are responsible for only about 10% of human birth defects. The scientific basis for understanding the risk of congenital malformations from exposure to environmental agents is based on several tenets of toxicology and embryology dogma. The first tenet is that essentially all teratogens that have been studied have a typical toxicologic dose response relationship and a no-effect dose. Secondly, the stage of gestation is critical to the effects that are expected, and all stages of embryogenesis and fetogenesis can have vulnerability to environmental toxicants. Thirdly, the response of the embryo and fetus is characteristic for each teratogenic agent, although there is some similarity in the effect of certain teratogens. Appropriately designed developmental toxicology studies and basic embryologic and biologic concepts are all used to estimate the potential reproductive hazard for embryonic death, growth retardation, congenital malformation, and functional deficit.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A number of important therapeutic agents have recently become available for the treatment of infectious and inflammatory skin diseases. Five of these drugs, calcipotriol, EMLA (eutectic mixture of local anesthetics), interferon-α 2a, cyclosporine, and acyclovir, are reviewed. Calcipotriol, a vitamin D analogue, has been shown to be useful but not curative in chronic stable plaque psoriasis in adults. Its use in children is being studied. EMLA is proving to be useful in the prevention of pain prior to minor procedures. The use of interferon-α 2a promises to be highly effective in the treatment of the complications of vascular lesions. Cyclosporine is a powerful immunomodulating agent. It has been used in the treatment of atopic dermatitis and psoriasis. Adverse effects limit its widespread use as a systemic agent. Topical cyclosporine has limited efficacy due to its poor penetration. Acyclovir has revolutionized the treatment of herpes simplex virus infections, particularly in reducing the morbidity and mortality of neonatal herpes. Whether it is indicated in varicella infection in normal children is questionable.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A wide range of topics can be covered when considering a review of respiratory therapeutics. This review focuses on advances and controversies in the therapy of asthma, including issues regarding medications such as inhaled β2-agonists, inhaled corticosteroids, cromolyn sodium, and theophylline. Bronchodilator therapy for acute viral bronchiolitis remains a controversial issue and is discussed in light of recent published manuscripts. Issues regarding surfactant therapy for respiratory distress syndrome remain prominent in the neonatal respiratory therapeutics literature and recent findings in this area are reported. Advances in the treatment of cystic fibrosis, as well as a review concerning the pulmonary toxicity of various medications used in the treatment of pediatric illness are discussed.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Monitoring anticonvulsant drugs may be unnecessary for many patients except those in high-risk groups such as those with metabolic disorders, neurodegenerative diseases, and history of past drug reactions. Several studies reviewed kinetic differences between children and adults. Plasma carnitine is often reduced by administration of anticonvulsants, although the clinical significance of this is uncertain. Midazolam and analgesics such as fentanyl have become popular for sedation for pediatric procedures. Several studies reviewed safety and kinetics of this method of sedation. The midazolam decreases memory for the procedure and reduces anticipatory anxiety. Several studies also reviewed use of methylphen-idate for hyperactivity and risks of tricyclic antidepressants in children.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

With this section, I review five areas of concern to the pediatrician in the office setting: sudden infant death syndrome, child maltreatment, oral rehydration therapy, infectious diseases, and vaccinations. In keeping with the structure of Current Opinion in Pediatrics, I focus on these topics through the vantage point of this past year's literature. I would be amiss, however, if my commentary neglected to integrate the impact of major factors, often regulatory, on pediatric practice and to acknowledge the precarious nature and thus the renewed challenge of children's health in the United States today.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID