ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Accidental exposure to drugs and household products in young children and self-poisoning by adolescents are common clinical problems of important concern to the general pediatrician. This article reviews new developments in the field of pediatric toxicology including 1) epidemiologic data collected from poison centers and hospital admissions that illustrate the changing spectrum of pediatric poisonings; 2) progress in identifying clinical features or laboratory tests predictive of outcome in specific poisoning; 3) advances in and limitations involving decontamination methods and antidote therapy in different toxic ingestions; and 4) recent investigations toward prevention of pediatric poisoning with an emphasis on barriers to compliance.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

By virtue of their ongoing relationship with families and young children, pediatric primary care providers are well positioned to participate in the early detection of children's behavioral, developmental, and psychosocial problems. Yet research suggests that many such problems elude early detection. Awareness of the prevalence of such problems should encourage pediatric providers to carefully elicit parents' opinions and concerns, obtain a relevant behavioral and developmental history, skillfully observe parent and child behaviors, and obtain, when indicated, the opinions of such other relevant professionals as preschool teachers. Possible strategies to improve early detection include the use of parent questionnaires, parent record-keeping of children's behavior, and a developmental screening tool as an aid to surveillance. The development of a classification system for such problems designed for primary care, rather than psychiatry, should also facilitate early detection.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In October 1991, the Centers for Disease Control and Prevention issued new lead guidelines, dramatically lowering the intervention level from 25 μg/dL of lead in blood to only 10 μg/dL and calling for universal screening. This review summarizes recent research findings on the effects of lead exposure on cognitive abilities and presents current information on sources of exposure to lead, methods of screening for lead poisoning, and options for treatment.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Recent psychobiologic research has provided new insights into the interplay between constitutional and environmental etiologies in stress-induced childhood illness. Individual differences in both psychobiologic reactivity and physiologic self-regulation may substantially influence a child's internal stress responses. In addition, the physiologic consequences of a given environmental stressor may depend critically on the developmental stage in which the stressor occurs. Behavioral changes associated with early exposures to stressors may be linked to alterations in central nervous system monoamine production and metabolism. Evidence for developmental and psychobiologic changes in response to very early, even prenatal, stressors suggests that environmental and genetic contributions to stress response profiles may ultimately be difficult to disentangle.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Infant mortality continues to be a major public health issue in the United States. Although some preventive strategies for neonatal mortality are emerging for congenital malformations, notably neural tube defects, the prevention of preterm deliveries among disadvantaged populations remains elusive, suggesting the need for different approaches to women's health needs. Despite the lack of success in preventing preterm birth, neonatal mortality rates continued to decline substantially, a decline attributed to improvements in neonatal intensive care associated with surfactant use. The increasing survival of very preterm infants continues to raise questions about their longer term outcomes especially with several recent studies on difficulties in school, and about the need for postdischarge developmental interventions. Attempts to decrease postneonatal mortality received marked attention with the recommendations for specific positioning to prevent sudden infant death syndrome and heightened attention to increased immunization completion rates. The dismal ranking of the United States in infant mortality rates among industrialized countries, however, continues to present a social policy challenge.

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

摘要:

Fat-soluble vitamin deficiency is known to result in various complications that may be prevented if the problem is recognized and managed appropriately. In infants and children with chronic cholestasis, replacement therapy of the fat-soluble vitamins, vitamins A, D, E, and K, may prove extremely difficult because low concentrations of intraluminal bile acids lead to malabsorption of these compounds and other fat-soluble substances. Recent progress in the use of a water-soluble form of vitamin E, d-cc-tocopheryl polyethylene glycol-1000 succinate, has enabled correction of vitamin E-deficiency states in these patients. It has also allowed for the admixture and coadministration of other fat-soluble vitamins and compounds in d-a-tocopheryl polyethylene glycol-1000 succinate to enhance their absorption. For managing vitamin K deficiency, similar success has been achieved using a vitamin K compound solubilized in glycocholate and lecithin. Vitamin A deficiency has been implicated in the higher incidence of childhood mortality and morbidity in Third World countries. Increased risk of childhood cancer has recently been associated with intramuscular injection of vitamin K to newborns. Finally, it is worth noting that among the pediatric population, exclusively breastfed infants, in general, are at risk for hypovitaminosis D, and at even greater risk in the absence of adequate exposure to sunlight or when the maternal diet is not sufficient to provide for vitamin D requirements.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Three main factors are needed for an infant to develop allergy: allergen exposure, a genetic predisposition, and contributory factors. Recent literature suggests that the incidence of in utero sensitization might have been underestimated up to now. A number of papers provide evidence that atopic dermatitis should be regarded as a manifestation of food allergy. The case for an immunologic mechanism of food allergy has been indirectly strengthened because of the apparent association between increased levels of antibodies to cow's milk proteins and insulin-dependent diabetes mellitus. The vast majority of recent papers deal with the prevention, and thus indirectly with the pathogenesis, of cow's milk protein allergy. In general, studies focusing on the prevention of cow's milk protein allergy in at-risk infants report “satisfactory” results, suggesting that in a majority of infants the decreased or reduced exposure to native cow's milk proteins not only delays but also eliminates cow's milk allergy. Experience with hypoallergenic formulas in therapeutic situations is disappointing. Skin-prick tests with hypoallergenic formulas are recommended before such a formula can be considered in allergic infants.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Infections of the gastrointestinal tract remain an important cause of childhood morbidity and mortality worldwide. A number of pertinent articles have appeared in the past year, advancing our understanding of 1)Helicobacfer pylori-induced gastroduodenal disease, 2)Escherchia coli O157:H7-mediated diarrhea, and 3) newer gastrointestinal parasites that cause diarrhea. These are the topics of review.

ISSN:1040-8703    

出版商:OVID    

年代:1993

数据来源: OVID