Biomedical subjects
Publications and source records attributed to W L Robson.
Snorers sleep through their obnoxiously loud breathing, but other members of their household often do not. Their bed partner and family members may grow so tired of the noise that they insist the offender seek medical attention. Physiologic problems such as obesity, narrowing of the airway, or inadequate oropharyngeal muscle tone often can be identified as the cause of snoring. Whenever possible, the underlying disorder should be treated.
We describe a girl with Prader-Willi syndrome and membranoproliferative glomerulonephritis. She had a deletion at 15q11-13. The deletion may have made the child susceptible to renal disease.
Neonatal circumcision continues to be a controversial subject. The American Academy of Pediatrics has revised its earlier policy, stating that newborn circumcision has potential benefits as well as risks and emphasizing the need to explain these issues to parents considering the procedure so that an informed decision can be made. Compared with circumcised males, uncircumcised males are at greater risk for urinary tract infection, sexually transmitted disease, phimosis, paraphimosis, and balanoposthitis. Complications of circumcision include infection, hemorrhage, and meatal stenosis. Analgesia should be prescribed for the substantial pain associated with the procedure. Alternatives to circumcision include retraction of the foreskin with use of local or general anesthesia. Regular foreskin hygiene is important for all males, whether circumcised or not.
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Renal ultrasonography was performed on 69 children who had a preauricular sinus. Three children (4.3%) were found to have a significant renal anomaly. Two children had hydronephrosis secondary to vesicoureteric reflux. One patient with branchio-oto-renal syndrome had an absent left kidney and a hypoplastic right kidney associated with two dysplastic arteries. Renal anomalies were significantly more common in patients with a preauricular sinus than the 1 percent incidence of renal anomalies reported in the general population. We recommend that renal ultrasonography be performed on all children with a preauricular sinus.
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Human bites are common during childhood and usually result from fights or aggressive play with another child. Bites may present as indentation marks, scratches, abrasions, contusions, or lacerations. Most human bite wounds are sustained on the upper extremities, followed by the face and neck, the trunk, and the lower extremities. Infection is the most common complication. Cultures of an infected bite wound yield an average of five microorganisms. This article reviews the current recommendations on the management of human bite wounds in children.
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Sixty-eight children with diarrhea-associated hemolytic uremic syndrome (D+HUS) were retrospectively examined to assess clinical variables associated with the combination of leukocytosis and hypocomplementemia. There was a statistically significant association between the white blood cell count (WBC) and the level of the third component of the complement system (C3). Children with both a low C3 and a high WBC were significantly younger and required hospitalization for a significantly longer period of time. Although there were also trends to increases in the presence of anuria and central nervous system complications and in the duration of anuria, elevated WBC, thrombocytopenia, dialysis, and hemorrhagic colitis in children with both an elevated WBC and a low C3, these changes did not achieve statistical significance. The presence of a low C3 and an elevated WBC may indicate a subset of children with D+HUS with a more severe episode.
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Lying is a common problem in children. The causes of lying are numerous. With proper management including good parental role models, minimising or preventing contributing factors, and appropriate discipline, most children outgrow the tendency to lie.