American journal of diseases of children (1960)
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Pancuronium bromide treatment in severely ill, mechanically ventilated infants has been shown to result in lower peak transpulmonary pressure, with an accompanying lower-than-expected incidence of pneumothorax. Infants, treated with pancuronium often demonstrate an ominous abdominal roentgenographic finding: the "gasless abdomen." Of 38 mechanically ventilated infants, 22 of 24 pancuronium-treated infants (as compared with four of 14 untreated infants) had diminished or absent bowel gas. ⋯ Pancuronium prevents swallowing of air but does not inhibit gut peristalsis, thus accounting for the evacuation of abdominal gas three hours or more after administration of the drug. Clinicians who treat infants with pancuronium should be aware of the phenomenon, to avoid needless roentgenographic studies.
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Two hundred children aged 6 months to 12 years were admitted to the hospital with a foreign body in the airway. Food materials constituted 93% of all foreign bodies. A positive history of foreign body aspiration was obtained in 88% of the cases. ⋯ History of recurrent intractable pneumonia should make one consider a foreign body in the airway. Removal of one foreign body does not exclude the existence of another. The condition may be fatal; thus immediate removal of the foreign body is mandatory.
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Recurrences of CNS infarction often lead to progressive neurologic disability in sickle cell anemia. To prevent such reccurrence, a periodic blood transfusion program was begun in 1969. Currently, 27 patients are on this regimen. ⋯ In addition, there was a striking decrease in bacterial infection and pain. We conclude that periodic transfusions are effective in preventing recurrent CNS infarction in sickle cell anemia. The benefits must be weighed against the potentially serious problem of iron overload, as evidenced by moderately elevated serum ferritin values.
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A multidisciplinary child abuse team investigated children with burns admitted to a general hospital in Tulsa, Okla. Of the 26 burn cases investigated, 14 were found to be accidental, seven accidental with extreme degrees of neglect, and five nonaccidental burns. ⋯ The high mortality of the abused group indicates the seriousness and severity of nonaccidental injuries. This experience has also shown that nonaccidental burns in children demand a thorough investigation of medical, social, and emotional factors.
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Case Reports
Group B streptococcal sepsis with osteomyelitis and arthritis. Its occurrence with acute heart failure.
In a 20-day-old female infant, bacteremia, osteomyelitis, and pyogenic arthritis developed due to infection with group B streptococcus, type Ic. She had an unusual clinical presentation with overwhelming sepsis and acute congestive heart failure.