American journal of diseases of children (1960)
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Case Reports
Group a beta-hemolytic streptococcal pneumonia: clinical course and complications of management.
Three childhood cases of beta-hemolytic streptococcal pneumonia are presented with a review of the literature. The disease, though uncommon in childhood, results in severe local and systemic effects. ⋯ Early and vigorous drainage of the pleural cavity is essential to successful outcome. It appears that predisposing viral disease, including influenza, is essential for acquisition of this form of bacterial pneumonia.
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Thirteen of 356 children consecutively admitted for treatment of status asthmaticus in a 37-month period experienced 19 episodes of respiratory failure, an incidence of 5.3%. In this retrospective study, all children received similar pharmacologic therapy after admission, and all were treated with nasotracheal intubation and controlled ventilation with a volume-cycled ventilator. ⋯ Complications occurred in nine of 19 episodes and there was one death not directly related to acute asthma. It is possible that 12 of the 19 episodes of respiratory failure might have been prevented by more prompt or more appropriate treatment of the child with acute asthma.
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We evaluate three cases of acute hemiplegia in childhood complicated by tremor and/or choreoathetosis. Each patient experienced the abrupt onset of hemiplegia thought to be localized to an insult involving the middle cerebral distribution without associated seizure, trauma, loss of consciousness or demonstrable cardiac, hematological or neoplastic causes. ⋯ These disorders included resting and intention tremors, as well as choreoathetosis. Anticholinergic drugs failed in treating two patients, but biofeedback techniques were quite successful in one of the two patients so treated.
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It has been shown that a patent ductus arteriosus may complicate the course of the respiratory distress syndrome (RDS) in preterm infants. In this study, an attempt is made to answer the question: Is there any relationship between RDS and patency of the ductus arteriosus in preterm infants, that is, do preterm infants without the RDS have early functional closure of the ductus arteriosus? Clinical observations were made on 144 preterm infants 25 to 34 weeks' gestation. Infants were included in the study if the status of the ductus arteriosus (open or closed) could be established either by clinical examination or retrograde aortography. ⋯ None of the infants with a closed ductus had severe RDS and only three had mild RDS. In contrast, 50% (43 of 85) of infants with open ductus had severe RDS. These findings suggest that early functional closure of the ductus can occur even in very immature infants, and this early closure appears to be associated with a decreased incidence of RDS.
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Two hundred fifty-one patients with Down syndrome and congenital heart disease was based on clinical (41%), catheterization (38%), surgical (11%), or autopsy data (10%). The most common lesions were endocardial cushion defect (43%), ventricular septal defect (32%), secundum atrial septal defect (10%), tetralogy of Fallot (6%), and isolated patent ductus arteriosus (4%). Thirty percent had multiple cardiac defects. ⋯ Motality in the 68 patients undergoing surgery was 26% for open heart procedures and 11% for closed heart surgery. In 32% of nonsurgically treated patients with large left-to-right shunts, irreversible pulmonary vascular disease developed. Improved medical and surgical care have decreased morbidity and mortality in these patients in recent years.