Current opinion in pediatrics
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Curr. Opin. Pediatr. · Feb 1995
ReviewOffice evaluation and treatment of finger and hand injuries in children.
Injury is our children's greatest health problem, and pediatricians will frequently see finger and hand injuries in the office and emergency room. Many of these will be fingertip crush injuries, which are quite common in toddlers and are often undertreated. Pediatric finger and wrist fractures and sprains generally do well but require proper diagnosis and treatment. ⋯ Advances in microsurgery allow replantation of distal amputations even in young children and infants, although often not without complications. Thermal injuries and animal bites require early and aggressive treatment. As with many pediatric hand injuries, these injuries should be preventable, and the adverse consequences can be minimized with appropriate diagnosis and management.
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Curr. Opin. Pediatr. · Dec 1994
ReviewCurrent approaches to genetic metabolic screening in newborns.
Genetic metabolic screening in newborn infants includes both specific testing for clinical indications in sick neonates and routine newborn screening. The decision of which sick neonates should have metabolic testing is based on the clinical phenotype and the results of general laboratory analyses, with particular attention to hypoglycemia, metabolic acidosis, and hyperammonemia. ⋯ The disorders covered by newborn screening vary among the states and among countries but virtually always include phenylketonuria and congenital hypothyroidism and often include sickle cell disease and galactosemia. Other metabolic disorders that may be included in newborn screening are maple syrup urine disease, homocystinuria, biotinidase deficiency, and congenital adrenal hyperplasia.
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Curr. Opin. Pediatr. · Oct 1994
ReviewFirearm injuries in children and adolescents: epidemiology and preventive approaches.
Firearm injury, now a leading cause of death in childhood and adolescence, had jointed the ranks of pediatric conditions that threaten child health and development. This paper reviews articles on epidemiology (of firearm injuries and the firearms themselves) and prevention. Epidemiology of injuries: 5356 Americans under 20 years of age died of firearm injuries in 1991; most of these were homicides, and most involved 15 to 19 years olds. ⋯ Among 5000 families attending pediatric offices, 32% owned handguns or rifles; 13% of handguns and 1% of rifles were stored unlocked and loaded. In a school survey, three-fourths of first and second graders who knew there was a gun at home knew where it was. Gun sales are very loosely under the jurisdiction of the Bureau of Alcohol, Tobacco, and Firearms; no regulations affect gun design, and oversight of commerce is extremely lax.(ABSTRACT TRUNCATED AT 250 WORDS)
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Curr. Opin. Pediatr. · Aug 1994
ReviewFactitious disorders and the psychosomatic continuum in children.
A continuum may be described as spanning between the psychological reactions of children and families to a child's illness, the exaggeration or simulation of symptoms for psychological reasons, and the production of factitious symptoms in the child by the parent. However, there are critical clues that allow the alert clinician to recognize where his patient falls on the continuum. Because factitious disorders are uncommon and Munchausen syndrome by proxy is rare, awareness of psychiatric and clinical signs is important to prevent morbidity or mortality.
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We review new research on childhood pain and trauma. We begin with studies on the expression and measurement of pain, pain management, recurrent abdominal pain, and brief and long-term memory of injury and medical procedures. We then review research on the impact of children's witnessing of pain in others as a result of injury or violence and children's experience of natural and man-made disasters. Finally we consider the links between pain, trauma, and memory and discuss our recommendations for the next steps to be taken.