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Presents a simplified method for mass screening for lead poisoning in children. Determination of the level of urinary δaminolevulinic acid; Comparison of the dipstick and column methods of urine assays; Ease of collecting samples by parents.

This paper deals with the kind of information that moderately retarded children do have and should have about sexual development, and with parental concerns about sexuality and their retarded child. The ideas expressed in this paper are directed to the pediatrician who may be asked for advice on these matters. Specific suggestions for working with moderately retarded (IQ usually 50 or below) children are proposed also. [ABSTRACT FROM AUTHOR]

The article discusses the screening of phenylketonuria (PKU) in newborn infants. With newborn infants, urine screening procedures have not proved as satisfactory for detection of PKU as with older infants and young children. A blood screening program for newborn infants complemented by later urine screening at appropriate times with appropriate age groups would appear to be the ideal program. Shortcomings of urine screening program include: urinary metabolites found in phenylketonuria may not be excreted in amounts detectable by FeCU or buffered ferric salt stick tests until after the infant is several weeks old; and FeCls diaper tests are less than 95 per cent accurate in PKU detection.

Focuses on the adequacy of teaching programs for production of well-rounded pediatricians. Awareness of the gaps in teaching several facts of medical education; Identification of various categories of experts in several field of medical.

Of three young patients with incarcerated umbilical hernia, two had a severe cough which increased intra-abdominal tension and forced a small intestinal loop into the sac. The third patient presented with a loop of transverse colon caught in the hernial sac; this infant was a paper eater and a bolus of paper had become trapped in the incarcerated colon. One patient needed an intestinal resection because of strangulation. Umbilical hernias can and do become incarcerated. Surgical therapy should be undertaken promptly if the hernia cannot be reduced immediately by sedation and manual manipulation. [ABSTRACT FROM AUTHOR]

"One purpose of this paper is to define, as precisely as possible, patterns of drug use in one subculture of the youthful population. Another of its purposes is to emphasize the distinction between "drug use" and "drug abuse." Among the patients in our clinic the taking of drugs is almost universal; abuse, on the other hand, is of a much lower order of magnitude. Admittedly, imprecisely defined criteria separate these practices. Furthermore, separation of drug use from drug abuse does not imply acceptance of the one and rejection of the other." [ABSTRACT FROM AUTHOR]

The article discusses followup screening tests for phenylketonuria in newborn infants. A urine test for phenylpyruvic acid and orthohydroxylphenylacetic acid is better than no followup testing. A blood test at 4 to 6 weeks of life if chromatographic methods are not used in the urine testing has distinct advantages over a urine FeCU or Phenistix test. Urine at 4 to 6 weeks examined by paper chromatography would reveal the presence of excess amounts of phenylalanine, and the method offers the advantage of examining the urine for other disorders characterized by aminoaciduria.

This article suggests that time is saved and record-keeping simplified if immunization records are attached to the outside of the envelope or folder containing the records of an entire family. The dates of immunizations are recorded in a series of boxes for each patient. A piece of properly fitted sensitized paper is placed inside the envelope. This sheet has a duplicate series of boxes for each of the immunizations on the outside of the envelope. When the nurse or physician records the date of an immunization on the outside of the envelope, it is simultaneously recorded on the sensitized paper inside the envelope. Primary advantages of this arrangement are the ease of accessibility and the time saved in finding the immunization records.

Shares the author's experience in his participation in the 1970 White House Conference on Children in December 1970 in Washington D.C. Privilege of the author to serve on one of the 25 forums, which were charged with responsibility of planning the meeting for one segment of the conference and preparing a position paper and other materials; Participation of distinguished laymen in the Developmental Child Care Forum; Excellence of the delegates who attended Forum 17 on Developmental Child Care in their attendance and interest and demonstration of considerable competence and experience in the area of child care.

Acute renal failure is a complicated disturbance, which taxes the clinical skills of (he physician. This paper reviews the metabolic derangements, the principles of treatment, the consequences, and the advances recently made in our understanding of the pathophysiology and management of acute renal failure. [ABSTRACT FROM AUTHOR]

The cryptophthalmos-syndactyly syndrome is a rare disorder of which approximately 55 cases have been reported in the world literature. A few have been described in the American literature. It is the purpose of this paper to report another case and to stress the Importance of early identification and of genetic counseling of the parents. [ABSTRACT FROM AUTHOR]

The continued success of hemodialysis and later kidney transplantation when feasible have made these the accepted and recognized modes of therapy for children with terminal renal disease. As survival rates improve, dietary therapy is most important in bringing the patients to transplant in the best possible condition. The present paper not only reviews the known nutritional principles in the control of renal failure, hut also offers practical guidelines and diets for good management of uremic infants and children. [ABSTRACT FROM AUTHOR]

The pediatrician is in a unique and powerful position, both in his own office and in his community. By taking an active role in designing, executing, and evaluating screening programs, he can help insure that resources are used economically and usefully, and that a broadened view of screening and health results in positive programs. He should insist that vital components of any screening program include intervention and dissemination of information to those who need it. To do less is to abdicate a responsibility which cannot be delegated to others, even though many screening programs are initiated and conducted by nonphysicians. [ABSTRACT FROM AUTHOR]

In a recent interview on the subject of teething in infancy, new opinions have been proposed to explain the mystery and myth that surrounds this subject.' This paper presents a summary of these views, many of which are being published for the first time. [ABSTRACT FROM AUTHOR]

Otoscopy is a basic medical skill for which the electric otoscope is a primary tool. Surprisingly, a dearth of information exists regarding the otoscope, and little emphasis is being placed on otoscopy within crowded medical school curricula. A review of the recent literature and of textbooks going back to 1834) was of little help in uncovering studies directed towards establishing the essentials of a good otoscope. In order to ascertain current usages of otoscopy in pediatrics, we carried out a survey among practicing pediatricians, pediatric house officers, anti medical students. We also interviewed the two largest manufacturers, to gather information regarding the bases of the design and construction of their instruments. This paper summarizes our findings and comments on the major diagnostic and therapeutic aspects of pediatric otoscopy. [ABSTRACT FROM AUTHOR]

Characterizes the condition of diaper dermatitis. Difference between infants and adults' skin; Natural defenses of the skin against the sun and other environmental threats; Types of skin diseases occurring in the bathing trunk or diaper area; Complications of diaper dermatitis; Ways of managing the condition.

This paper reports two cases of acute pulmonary edema successfully treated, when medical management failed, with continuous positive airway pressure (CPAP) and spontaneous breathing. The clinical, laboratory, and radiological findings indicate that this technic offers an alternative to mechanical ventilation when respiratory failure complicates pulmonary edema in infants. [ABSTRACT FROM AUTHOR]

This paper endeavors to assist the pediatric practitioner in determining when to refer a patient to a clinical child psychologist, and to give him some idea of what can be expected from a psychologic evaluation. The more specific the referral questions, the more meaningful the answers the pediatrician receives. Included are some pointers on preparing a child for a psychologic examination. [ABSTRACT FROM AUTHOR]

This paper discusses the common theories on the cause of enuresis and reviews current approaches to its management in the light of a suggested pathogenetic mechanism. [ABSTRACT FROM AUTHOR]

Drug abuse is abused in that current approaches largely fail to recognize drug abuse as a symptom of underlying disease. The concerns of medicine, religion, and the state have been to correct the symptom, rather than to attack its causes, as our rapidly changing technologic society progressively deprives us all of several needs basic to our well-being. One response has been drug abuse, often arising from the hunger for love, understanding, and a meaning to life in our increasingly dehumanizing culture. Essential ingredients in the development of identity are religion and ritualization; if healthy, normative sources are unavailable or unattractive, drugs may be chosen. "In this paper I should like to discuss some lesser-realized aspects of drug abuse in a special group of our youth, to stress some root causes of the problem." Medicine and religion must communicate with and educate our youth and ourselves, and become advocates of youth's plight and needs. Details are given. [ABSTRACT FROM AUTHOR]

The art of simple physical examination is still valuable. Faced with a child suspected of having Down's syndrome, a lack of facilities for chromosome analysis, and anxious parents, the physician can often make the diagnosis with a high degree of accuracy by a thorough physical examination, performed with the help of a check-list of frequently found signs. This paper compares the results of physical examination with those of chromosome analysis in 150 patients. [ABSTRACT FROM AUTHOR]

The article presents a paper that discusses the problems with intrauterine contraceptive devices (IUDs), which have become the major contraceptive method in the Adolescent Clinic program. One of the major health problems at the Adolescent Clinic of the Cincinnati General Hospital, Ohio, has been pregnancy and repeat pregnancy in the adolescent. The clinic has initiated a program of management for the pregnant adolescent girl, which has a strong emphasis on prevention of repeat out-of-wedlock pregnancy. As is being reported elsewhere, there has been a significantly reduced rate of repeat pregnancy among adolescent girls who were well informed on contraceptive methods. Patients and parents were counseled about contraceptive methods by some member of the clinic staff. When an IUD was recommended, the patients and parents were given thorough instructions about its function and side effects, a pelvic model was demonstrated, and self-examination to check for IUD strings explained. Specific permission for IUD insertion was obtained from the parent or guardian. If problems arose after the insertion, a physician was available at all times.

Iron-deficiency anemia in the newborn infant frequently is not recognized. This paper provides two illustrations of this disorder in the neonate, and outlines the pathogenesis as well as the laboratory tests necessary to establish the diagnosis. The discussion includes a differential diagnosis of anemia at birth. [ABSTRACT FROM AUTHOR]

This paper presents the results of an analysis of the major causes of death and their relative importance in various age groups of children admitted to Mulago Hospital over two years. The shortcoming of such results is that they are not representative of the deaths in the community. However, they provide needed information before country-wide vital statistics become available. [ABSTRACT FROM AUTHOR]

In this paper we deal with those adverse parental attitudes which are the most serious and the most common. Since we usually deal with the mother we will concentrate on her attitudes and extend the discussion to the father where appropriate. [ABSTRACT FROM AUTHOR]

This practical paper is to be studied rather than read, memorized rather than skimmed, The contained information should be the "stock-in-trade" of every physician who takes care of infants and young children. [ABSTRACT FROM AUTHOR]

This paper describes observations on an additional 50 infants as related to their patterns of irritability, the soft-tissue contours of areas involved in cortical osteogenesis and the progressive bone changes which are sometimes seen. The clinical findings to which attention is being directed primarily are those of irritability, soft-tissue changes over involved bones with associated tenderness and occasional pseudoparalysis. The observations suggest that the pain and irritability depend on several factors. The most important of these is the child's ability to tolerate pain. Usually the infant who does not exhibit irritability or colic also is the child who shows little or no discomfort with illnesses that ordinarily are accompanied by pain. The concern of the parents also affects the reported incidence of crying. If the subject is avoided only extremely irritable infants are reported to the clinician.

The association of abnormalities of the lymphoreticular system with abnormalities of the cardiovascular system has long been recognized; for example, individuals with absence of the spleen have a high incidence of congenital heart disease. In 1959, Lobdell described a child with absence of the thymus, anomalies of the aortic arch, no parathyroids and clinical hypoparathyroidism. In 1960, a second similar case was reported from the Children's Medical Center in Boston. In 1965, DiGeorge recognized that such patients had normal immunoglobulin production but did not develop delayed hypersensitivity or reject a homograft. At least 20 additional cases of 'third and fourth pharyngeal pouch syndrome' have been placed in the literature in the past few years. This paper reports two additional cases with absence of the thymus and parathyroids, and emphasizes the association of these anomalies with vascular anomalies of the great vessels.

The article focuses on nine case histories related to psychogenic cough tic. Tics are sudden, purposeless, quick, involuntary and frequently repeated movements of circumscribed groups of muscles. The article briefly summarize cases, review the sparse literature and discuss the need for earlier diagnosis of this pediatric entity. There is a surprising lack of information in the pediatric literature on psychogenic cough tic. The two best papers are from the fields of allergy and otolaryngology. All nine patients were older children or adolescents. Coughing began during the school year in each and lasted for several weeks or months. The most common months for onset of cough in patients were October, November, December and January. No patient began to cough during the summer months. Fever, hoarseness, stridor or wheezing do not precede or accompany cough tics. School phobia was a contributing cause of psychogenic cough tic in eight of nine patients. None of the patients improved with the most potent cough mixtures or antibiotics; everyone responded to tranquilizers, suggestion and reassurance.

In the "Pothumous Papers of the Pickwick Club," Charles Dickens in 1837 described a fat and red-faced boy in a state of somnolence. From this description and with the development of pulmonary function tests, the term Pickwickian syndrome has been coined. This article describes the eighth reported child and the third coming to autopsy in literature. The most important etiologic and immediate factor in the pathologic physiology of the Pickwick syndrome is extreme obesity. Noteworthy was the tremendous obesity and severity of the cardiorespiratory disturbances which ultimately led to the child's death.

We are increasingly aware of the harm, both actual and potential, done to patient and parents from the designation of children with delayed and irregular maturation as "brain-damaged" or "suffering from brain dysfunction". The terror and anxiety wrought by such diagnosis, despite the fact that they are based on no current evidence of actual brain disease, is the topic of this paper. [ABSTRACT FROM AUTHOR]

This paper presents the incidence of growth failure in 44 patients for which no organic cause was discovered after investigation. This group of patients, collectively termed failure-to-thrive, represents the second largest diagnostic category of patients with growth failure admitted to a children's hospital in one year. An examination of various features of this group from a review of the medical and psychosocial histories is made and changes in growth patterns in hospitalization and follow up are documented. [ABSTRACT FROM AUTHOR]

It has been recognized for many years that the thyroid gland has an important role in promoting the maturation and differentiation of certain vertebrates; a remarkable example of this is the effect of thyroid hormones on the metamorphosis of amphibia. In man, a deficiency of thyroid hormones is known to induce immaturity and underdevelopment in congenital or juvenile hypothyroid states. A less well-known aspect of thyroidal influence on human development is presented in this paper which discusses the accelerated growth in fetal hyperthyroidism.

Over the past few years, the author has developed a classification of children's emotional disorders and, in Part I, has presented and discussed the place of school achievement problems in this classification. A recapitulation of Part I will be found in the summary. The categories of the classification suggest a direction of management. Part II continues the analysis of the case records of the 162 consecutively referred children who are the subjects of these papers. It describes the treatment methods applied as determined by the classification categories, the case management decisions made at the end of the evaluation period, and the results of a two-year follow up study. [ABSTRACT FROM AUTHOR]

The ubiquitousness of certain protozoan and helminth parasites and the increasing geographic mobility of individuals point up the need for an awareness of the role of parasitic infections in pediatric practice, This paper (a) surveys the advances in diagnosis and clinical understanding of those parasitic diseases of children which are the most common in Northern temperate climates—amebiasis, giardiasis, pin-worm infestation, visceral larva migrans, toxoplasmosis, pneumocystosis—and (b) surveys the usefulness, specificity, and limitations of the newer serologic tests in the diagnosis and management of these diseases. Therapy is not stressed. Because of the recent recognition of the significance of Pneumocystis carinii infection, this is considered in somewhat greater detail than its rarity might otherwise warrant. [ABSTRACT FROM AUTHOR]

The paper presents the results of a survey on cases of idiopathic sexual precocity with reference to the relation between physical precocity, chronologic age, IQ and school grade level. The best sampling criterion was a diagnosis of idiopathic sexual precocity. Intelligence tests had been given to the patients over the years by four different people and put on file. The patients fall into three categories with respect to progress in school: (1) those for whom accelerated admission and/or skipping a grade was accomplished (12 cases); (2) those for whom early school admission or later acceleration was recommended, but either not accomplished or not subsequently reported (eight cases) and (3) those for whom school acceleration was not pragmatic and was not recommended (25 cases).

The paper briefly discusses the action of the ototoxic antibiotics on the human labyrinth, reviews their pharmacologic properties and summarizes their clinical indications. The ototoxic antibiotics are a group of drugs with remarkable pharmacological similarities. Most ototoxic antibiotics cause severe damage and destruction, primarily of the sensory cells of the inner ear. The available data indicate that these cells depend mainly on glucose for energy, and that ototoxic antibiotics damage the apparatus for glucose breakdown. A good understanding of the absorption, distribution and excretion of the drugs is essential for safe therapeutic application. Unfortunately, administration to patients with renal insufficiency is at present the main cause of iatrogenic deafness. The necessary precautions and the changing indications for the drugs are outlined.

This paper calls attention to the formerly frequent use of ill-advised home remedies, and describes several recent cases in which the source of lead was identified as a home remedy. [ABSTRACT FROM AUTHOR]

This article describes the Guillain-BarrÉ syndrome in childhood. The syndrome is still a disorder of uncertain etiology and of variable clinical manifestations. Although traditionally looked upon as being rare in childhood, experience suggests that it occurs more commonly than suspected in this age period and seems to be increasing in incidence. A review of the literature up to 1940 disclosed only 19 childhood cases in the English and 19 in the French literature. The purpose of this paper is to define the syndrome and to review the clinical and other features of 19 pediatric patients with this disorder seen at the Children's Memorial Hospital, Oklahoma City, Oklahoma during the years 1951 through 1963.

This paper presents evidence from the literature to document the thesis that different approaches to child rearing lead to different recognizable behavioral reactions in some children. We also discuss how parental misunderstandings of these reactions can lead to vicious circle relationships that may interfere with their child's development. [ABSTRACT FROM AUTHOR]

Presents a paper recommended to the U.S.-Mexico Border Public Health Association meeting regarding the health problems of children of migrant families. Historical, social and economic considerations about the issue; Discussion on how to improve the health care of the migrant children; Role of the local physician in the administration of specific health measures.

This paper reviews the known relationships of common acute bacterial and viral respiratory infections to the asthmatic state and to wheezing attacks in children. Implications for treatment are discussed in view of what has already been learned and what we need to know. [ABSTRACT FROM AUTHOR]