Clinical pediatrics
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Clinical pediatrics · Jun 1993
Letter Case ReportsCerebrospinal fluid pleocytosis in children with pneumonia but lacking evidence of meningitis.
Headache, nuchal rigidity, positive Kernig's sign, and even convulsions may be observed during severe bacterial infections such as pneumonia, pyelonephritis, typhoid fever, and bacillary dysentery. In such cases, meningitis can be excluded only by documentation of normal cerebrospinal fluid (CSF). The authors describe four children with lobar pneumonia in whom the clinical signs of meningeal irritation were associated with a mild increase in the white blood cell count in the CSF (pleocytosis) although there was no other evidence of meningeal infection.
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Clinical pediatrics · Mar 1993
Case ReportsThird-degree burn following use of microwave-heated cryogel pack.
It is common nursing practice to apply warm soaks to an area where extravasation of intravenous (IV) fluid has occurred. Here we report an adverse outcome due to the use of a microwave-heated, commercially available hot-cold cryogel pack to treat an extravasation of IV fluid in a patient.
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Clinical pediatrics · Feb 1993
Case ReportsIndications and application of epidural anesthesia in a pediatric population outside the perioperative period.
The techniques of spinal and epidural anesthesia have been key components of anesthetic care for the past 100 years. Although commonly used in the operating room, their use in children outside the perioperative period has been limited. The author presents his experience with the use of epidural anesthesia to provide analgesia in five children when parenteral narcotics were ineffective in treating pain associated with burns, sickle cell crisis, trauma, and malignancies. Additionally, the principles and adverse effects of epidural anesthesia are discussed.
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Clinical pediatrics · Feb 1993
Family experiences, attitudes, and household safety practices regarding firearms.
To assess families' experiences with shootings and firearm ownership and attitudes, 208 children aged 5 to 12 years were interviewed and 242 parents filled out a questionnaire, all at an urban hospital. Forty-three percent of the parents and 25% of the children had personal knowledge of shootings. Of the parents, 10% owned guns, of which only 21% were stored safely. ⋯ Parents' and children's attitudes toward firearms and children's gun play did not differ by level of mother's education; method of payment for, or site of, health care; income; or exposure to shootings. Children with personal knowledge of shootings more often expressed fears of being shot than did other children (52% vs 31%). The children in our study population were similar in their gun play and attitudes about gun use despite disparate socioeconomic backgrounds and exposure to shootings.