American journal of diseases of children (1960)
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During a 22-year period, 12 cases of spontaneous chylothorax in newborns were diagnosed at a large pediatric tertiary care center. Seven infants had right-sided effusions; only one effusion occurred on the left. Severe bilateral accumulations occurred in four nonimmune hydropic premature infants. ⋯ Oral feedings with standard or medium-chain triglyceride formulas were given in five; total parenteral nutrition was administered in seven. The conditions of two infants with copious and persistent drainage improved following surgery. All but one infant survived, and the chylothoraxes never recurred.
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We surveyed pediatric oncologists throughout the United States and families of children with acute lymphocytic leukemia diagnosed between 1977 and 1980 at Children's Hospital National Medical Center, Washington, DC, to determine what information is perceived by both parents and physicians as essential to convey during the initial presentation of a life-threatening diagnosis. Both groups considered the following topics critical for discussion at the initial conference: diagnosis and prognosis of disease, explanation of disease process, additional tests needed to confirm and/or supplement the diagnosis, immediate therapeutic plan, and the physician's availability. Additionally, both parents and physicians, with minor variations, agreed about the order in which information about the disease should be conveyed. Although acute lymphocytic leukemia was used as a model, this study suggests guidelines that could be utilized to train residents and guide physicians in crisis-counseling techniques in the presentation to parents of a diagnosis of life-threatening illness in their child.
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Motivated by four penetrating brain injuries to children caused by BBs, a study was undertaken to (1) assess the danger posed by nonpowder guns and rifles and (2) evaluate current regulations pertaining to these products. Data from the US Consumer Product Safety Commission indicate that there are many nonpowder firearm injuries, predominantly among males aged 5 to 24 years. ⋯ Despite the hazard they pose, nonpowder firearms are regulated loosely, such that young teens can legally purchase and use the products in most jurisdictions. We propose stricter regulations and other means to prevent serious and fatal nonpowder firearm injuries.