Acta paediatrica Scandinavica
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Acta Paediatr Scand · Mar 1981
Case ReportsAcrodermatitis enteropathica Reversibility of cerebral atrophy with zinc therapy.
A six-month-old Saudi boy with acrodermatitis enteropathica confirmed by low serum zinc and alkaline phosphatase levels is described. Both the patient and a sibling developed acrodermatitis enteropathica while entirely breastfed. ⋯ Cranial computed tomography initially showed marked central and cortical "atrophy" that improved on treatment with zinc sulphate. The importance of zinc for normal brain growth and function is well known and the improvement on cranial computed tomography could be explained by improved myelination.
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Acta Paediatr Scand · Jul 1980
Case ReportsCongenital hepatic fibrosis combined with protein-losing enteropathy and recurrent thrombosis.
Two siblings, suffering from recurrent thrombosis and protein-losing enteropathy are presented. Histopathological examination of the liver in one of the patients, who died of multiple thrombosis, showed changes characteristic of Congenital Hepatic Fibrosis. Coagulation studies in the second child revealed decreased antithrombin-III in plasma, which might have had pathogenetic implications for the thrombosis tendency seen in both patients.
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Reflex sympathetic dystrophy in paediatric patients is a rarely recognized pain syndrome probably of neurovascular origin. The manifectations in two young females consisted of disabling pain and localized hyperesthesia in lower extremities without evident trauma. Sympathetic block followed by active mobilization and, in the patient with atrophic changes, lumbar sympathectomy, resulted in complete recovery. Reflex sympathetic dystrophy should be considered in the differential diagnosis of pain and tenderness in an extremity.
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In a 9-month period, 227 children attended the Accident and Emergency Dept. of the Children's Hospital, Sheffield, after accidents on the road--about 12% of all new attendances. 169 were accidents to pedestrians, 31 to cyclists and 27 to passengers. Of the 169 pedestrian accidents, 157 were hit by moving vehicles, 72 (45.9%) suffering serious injury, with two dead. 45% of the pedestrians, 22.6% of the cyclists and 11.1% of the passengers were admitted. 29.6% of the 227 had severe head injury (concussion with or without a fractured skull). 22% of the 227 had a fracture or fractures. 55 children had had previous accidents. Compared with 225 previously described skateboard injuries and 200 playground equipment injuries, those injured on the roads were much more serious, though with fewer fractures. 37% of the road accidents were serious, compared with 10.7% of those injured on skateboards and 7.5% of the play equipment cases; 40.9% of the skateboard injuries but only 22.0% of the road accidents involved fractures, but 29.6% of the latter, 6.0% of the play equipment injuries and 0.9% of the skateboard injuries involved serious head injury. 4.0% of the skateboard injuries, 10.0% of the play equipment injuries, but 45.0% of the pedestrian road accident cases necessitated admission.
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Acta Paediatr Scand · May 1979
Comparative StudyQuality of care: a tracer diagnosis study of acute otitis media, comparing a district paediatric service with paediatric and otolaryngology emergency departments.
Acute otitis media was used as a tracer condition for comparing patient care as regards patient satisfaction, compliance and medical outcome in a district paediatric office, an otolaryngological and a paediatric hospital emergency department. The initial work-up of the 216 patients studied at the three units was in good agreement with predefined standards. However, while the district paediatrician arranged a follow-up for all patients, the hospitals did so only in 10--30% of the visits. ⋯ The majority of the parents expressed preference for the type of care given in a neighbourhood service. It is suggested that the criteria for adequate treatment of acute otitis media adapted for emergency departments may be revised in case easy access is provided to a medical centre offering continuity of care and proper follow-up. Studies of the quality of care have so far not managed to demonstrate a definite and positive relationship between the process of care, patient satisfaction and final medical results.