American journal of diseases of children (1911)
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Herpetic whitlow is a herpes simplex virus infection of a distal phalanx. It is characterized by pain, swelling, erythema, and nonpurulent vesicle formation. Herpetic whitlow follows direct inoculation (exogenous or autogenous) or reactivation of latent virus. ⋯ The diagnosis of herpetic whitlow is readily confirmed by Tzanck test and culture. It is important to distinguish herpetic whitlow from bacterial felon or paronychia, as herpetic whitlow is a self-limited infection for which surgical incision is not indicated. We described herpetic whitlow in five children, one adolescent, and two pediatric residents.
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Comparative Study
Respiratory status of children with epiglottitis with and without an artificial airway.
During a ten-year period, 22 children from our 170 cases of acute epiglottitis had reliable records of arterial blood gas data. The arterial/alveolar (a/A) oxygen tension ratios were calculated, with a value less than 0.75 representing abnormal gas exchange. ⋯ Thirty-three percent of initial chest roentgenograms were abnormal, with the major disorder being atelectasis and/or consolidation. We propose that the radiologic and gas exchange abnormalities result from the common pathophysiologic mechanism of increased lung water.
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Biography Historical Article
The first published report of an incubator for use in the care of the premature infant (1857).
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Seventeen children with sickle cell anemia received 40 partial exchange transfusions for serious complications of sickle cell anemia, and preoperatively to reduce the risk of anesthesia. Each patient received two partial exchange transfusions at 24-hour intervals and all patients tolerated the exchange transfusions well. ⋯ Patients with acute lung syndrome had remarkable improvement in clinical symptoms and PaO2 levels, and those with acute liver crisis had substantial reduction in serum bilirubin levels. All the other patients showed marked clinical improvement following the exchange transfusions.
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Gout is rarely noted as a clinical problem in secondary polycythemia-- even if profound polycythemia exists, as in cyanotic congenital heart disease. A retrospective study of 81 patients with congenital heart disease was done to assess the incidence of hyperuricemia. Twenty of 46 patients with cyanotic congenital heart disease had serum levels of uric acid greater than 8 mg/dl. ⋯ For cyanotic patients, serum levels of uric acid were related directly to the degree of polycythemia (r = .44; P less than .02). Impaired renal function or drug therapy did not seem to account for the hyperuricemia. Because levels of uric acid greater than 10 mg/dl probably are nephropathic, many of these patients may be incurring subclinical uric acid nephropathy.