Commentary on child abuse and neglect.
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Biomedical subjects
Publications and source records attributed to R D Krugman.
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Maltreatment in childhood can result in problems that eventually present to the internist. The common somatic, psychosomatic, and psychiatric presentations in adults are reviewed. Mental health referral is often appropriate. When a case of child abuse is reported to the physician by a patient, the physician's legal responsibilities and protections are summarized.
This article reviews the recent history of responses to child abuse and the present roles of pediatricians. It outlines actions that are needed to protect children, recognizes the difficulties in effecting intervention, and concludes that pediatricians cannot afford to stand by while children continue to suffer harm.
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Sexualized attention is defined as a behavioral interaction between a caregiver and a preverbal child in which the adult appears to be sexually stimulated or involves the child in sexually stimulating games. Four cases involving parents whose infants had already exhibited physical signs of abuse or neglect are presented. Research and practice implications of this exploratory concept are discussed, and caution is urged with regard to its diagnostic application.
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The role, functions, activities, educational preparation and relationship with other health professionals of a new type of primary health care provider is described. The name gyniatrician has been applied to this kind of physician, who will be qualified to provide overall primary health care for women from the onset of puberty through adult life.
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Five years after primary infant immunization with trivalent oral poliovirus vaccine, employing either a three-dose primary series as recommended by the U.S. Public Health Service Advisory Committee on Immunization Practices (ACIP) or a four-dose series as recommended by the Committee on Infectious Diseases of the American Academy of Pediatrics. 115 children were serologically tested for persistence of neutralizing antibodies by the microneutralization test. Of the 57 individuals immunized according to the ACIP recommendation, antibody persistence was demonstrated in 92% for type 1 poliovirus, 98% for type 2, and 84% for type 3. Of those 58 individuals originally receiving a four-dose primary infant immunization series, the persistence of antibody was 98% to type 1, 98% to type 2, and 87% to type 3. Twenty-one of 24 negative sera showed neutralizing ability when tested by a more sensitive plaque reduction test. Thus, individuals completing either immunization schedule demonstrated satisfactory persistence of neutralizing antibody to all three poliovirus types over a five-year period.
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