ABSTRACT
After a description of child abuse and neglect among young children in the literature, the authors focus on the recognition of the problem by professionals. They describe the clinical symptoms which are found among battered and neglected children. When faced with this non specific and polymorphic symptomatology, they provide means to reach the diagnosis. They conclude with a brief description of the behaviour one should adopt when dealing with the children as well as with the legal protection system.
Subject(s)
Child Abuse , Child , Child Abuse/diagnosis , Child Abuse/psychology , Child Abuse, Sexual/diagnosis , Child Abuse, Sexual/psychology , Humans , Infant , Wounds and Injuries/diagnosisABSTRACT
Hereditary pyropoikilocytosis is a congenital haemolytic anaemia recently described. A new case is reported in which the condition was diagnosed by a study of erythrocyte membrane proteins in the parents. The unusual clinical features of this case lead to a discussion of the relationship between hereditary pyropoikilocytosis and other rare forms of elliptocytosis in children.
Subject(s)
Anemia, Hemolytic, Congenital/blood , Erythrocytes, Abnormal/pathology , Hemolysis , Erythrocytes, Abnormal/analysis , Hot Temperature , Humans , Infant, Newborn , Male , Spectrin/analysisABSTRACT
The observation of two cases of thrombophlebitis of the calf which occurred in two sisters within a period of three years is reported. The investigation revealed in both cases the presence of a circulating anticoagulant with anti-prothrombinase activity in association with biological signs of systemic lupus erythematosus (L.E.): anti-DNA antibodies, decreased complement levels, false positive BW reactions. In one patient, the skin biopsy showed a continuous IgM band on immuno-fluorescence. After respectively 4 years and 18 months follow-up both patients are still free from clinical symptoms. A review of the literature is presented and the clinical and etiological significance of the presence of a circulating anticoagulant, its relationship with L.E., particularly with "latent" L.E. (presence of biological signs only), and its association with thrombophlebitis are discussed.
Subject(s)
Blood Coagulation , HLA Antigens/analysis , Lupus Erythematosus, Systemic/blood , Thrombophlebitis/blood , Child , Female , Humans , Lupus Erythematosus, Systemic/genetics , Lupus Erythematosus, Systemic/immunology , Thrombophlebitis/diagnosis , Thrombophlebitis/geneticsSubject(s)
Mycobacterium Infections, Nontuberculous , Mycobacterium Infections , Skin Ulcer/etiology , Child , Debridement , Humans , Male , Mycobacterium Infections/microbiology , Mycobacterium Infections, Nontuberculous/microbiology , Nontuberculous Mycobacteria/isolation & purification , Skin Ulcer/microbiology , Skin Ulcer/surgeryABSTRACT
Study of ACTH responsiveness to oral metyrapone and insulin hypoglycemia in children with repetitive nervous system manifestations (convulsions, coma, mental confusion apathy, tremor) has led to diagnosis of isolated ACTH deficiency in nine children within a three year period. Hypoglycemia was ascertained in five children; in four cases no hypoglycemia was proved, possibly because of promptly disappearance or because of other mechanisms accounting for clinical symptoms (occurrence of intracellular overhydratation associated with corticol deficiency is considered). The incidence of isolated ACTH deficiency in children is possibly undervalued. Reappraisal of isolated ACTH deficiency in childhood as to be considered in idiopathic spontaneous hypoglycemia and perhaps in some paroxysmal neurologic and/or digestive manifestations without proved hypoglycemia and so far poorly defined or held for epileptic fits. In order to disclose further additional tropic hormone deficiencies, and to differentiate permanent from transient impairment of ACTH responsiveness which often seems to be related to emotional deprivation syndrome, more protracted follow up studies are needed.
Subject(s)
Adrenocorticotropic Hormone/metabolism , Nervous System Diseases/metabolism , Adolescent , Adrenocorticotropic Hormone/blood , Adrenocorticotropic Hormone/deficiency , Blood Glucose/metabolism , Child , Child, Preschool , Female , Humans , Hydrocortisone/blood , Hypothalamo-Hypophyseal System/physiopathology , Male , Metyrapone , Pituitary-Adrenal System/physiopathologyABSTRACT
A study of ACTH response to orally given metyrapone were carried out with 32 normal subjects aged 18 months to 15. Effectiveness of adrenal inhibition was supported by delta F > 5 microgram or cortisol level after metyrapone < 3 microgram/100 ml. The strong positive correlation between delta F and delta ACTH indicates the high sensibility of delta ACTH as an index of the responsiveness. No correlation was found between delta ACTH and weight, height, or age. Mean level (M +/- 2 SEM) are established: plasma ACTH level at 8 before metyrapone = 32,1 +/- 7,5 pg/ml; plasma ACTH level at 8 after metyrapone = 271,8 +/- 57 pg/ml; delta ACTH = 240 +/- 6 pg. Including these considerations, biological ACTH variability, and reproductibility of determinations, an abnormal response seems to be proved by plasma ACTH level at 8 after metyrapone < 100 pg/ml or/and delta ACTH < 70 pg. A normal response is established by delta ACTH > 150 pg.
Subject(s)
Adrenocorticotropic Hormone/blood , Metyrapone , 17-Hydroxycorticosteroids/urine , Administration, Oral , Adolescent , Adrenocorticotropic Hormone/metabolism , Child , Child, Preschool , Humans , Hydrocortisone/blood , Infant , Metyrapone/administration & dosage , Reference Values , Time FactorsABSTRACT
An 8-year old girl suffering from chronic relapsing staphylococcal skin infection since the first days of life was found to have extremely high (up to 26,500 units/ml) serum IgE levels and impaired polymorphonuclear chemotaxis. The other immunological tests appeared to be normal. There seemed to be a correlation between impaired chemotaxis and rise in IgE, the latter perhaps being related to a deficiency in some thymus-dependent lymphocyte functions.
Subject(s)
Hypergammaglobulinemia/complications , Immunoglobulin E/metabolism , Skin Diseases, Infectious/complications , Staphylococcal Infections/complications , Chemotaxis, Leukocyte , Child , Chronic Disease , Female , Humans , Hypergammaglobulinemia/immunology , Immunoglobulins/analysis , Lymphocyte Activation , Lymphocytes/immunology , Rosette Formation , Skin Diseases, Infectious/immunology , Staphylococcal Infections/immunologyABSTRACT
6,391 school children in the department of Seine-Saint-Denis were studied to determine the normal limits of blood pressure, its variations with age and sex, and its correlations with height, weight and heart rate. Blood pressure has a nearly perfect Gaussian distribution. Average blood pressures increase linearly with age according to sex. Boys have higher systolic blood pressures after the age of 14 and higher diastolic blood pressures after the age of 16. The estimated incidence of hypertension was 3,1% systolic hypertension and 2.2% diastolic hypertension. There was a very close relationship between systolic and diastolic blood pressure. Average systolic and diastolic blood pressures increased very significantly with height and weight, in both sex. Heart rate decreased with age. The average blood pressure was not related to heart rate. Blood pressure charts, related to age, sex, height and weight, allow follow-up of arterial blood pressure as children grow up and may lead to a better understanding of the mechanism of hypertension.
Subject(s)
Aging , Blood Pressure , Body Height , Body Weight , Adolescent , Child , Diastole , Female , Heart Rate , Humans , Hypertension/diagnosis , Male , SystoleSubject(s)
Blood Pressure , Hypertension/prevention & control , Adolescent , Aging , Child , Female , Humans , Male , Reference ValuesSubject(s)
Adrenocorticotropic Hormone/blood , Metyrapone , Adolescent , Child , Child, Preschool , Humans , Infant , Reference Values , Time FactorsSubject(s)
Purine-Pyrimidine Metabolism, Inborn Errors/diagnosis , Xanthine Oxidase/deficiency , Xanthine/urine , Child , Diagnosis, Differential , Female , Humans , Hydronephrosis/diagnosis , Hydronephrosis/genetics , Hydronephrosis/surgery , Male , Pedigree , Purine-Pyrimidine Metabolism, Inborn Errors/genetics , Purine-Pyrimidine Metabolism, Inborn Errors/surgery , Ureteral Calculi/diagnosis , Ureteral Calculi/genetics , Ureteral Calculi/surgery , Ureterostomy , UrographySubject(s)
Osteochondrodysplasias/diagnosis , Abnormalities, Multiple/diagnosis , Abnormalities, Multiple/genetics , Abnormalities, Multiple/pathology , Biopsy , Craniofacial Abnormalities/diagnosis , Craniofacial Abnormalities/genetics , Craniofacial Abnormalities/pathology , Diagnosis, Differential , Electromyography , Facies , Female , Humans , Infant , Male , Muscle, Skeletal/pathology , Neurologic Examination , Noonan Syndrome/diagnosis , Noonan Syndrome/genetics , Noonan Syndrome/pathology , Osteochondrodysplasias/genetics , Osteochondrodysplasias/pathologySubject(s)
Angiokeratoma/pathology , Fabry Disease/genetics , Fabry Disease/pathology , Kidney/pathology , Skin Neoplasms/pathology , Adult , Angiokeratoma/diagnosis , Angiokeratoma/genetics , Child , Child, Preschool , Chromosomes, Human, X/genetics , Fabry Disease/diagnosis , Female , Genes, Recessive , Genetic Carrier Screening , Glycosphingolipids/urine , Humans , Leukocytes/enzymology , Male , Microscopy, Electron , Sex Chromosome Aberrations , Skin Neoplasms/diagnosis , Skin Neoplasms/genetics , Trihexosylceramides/urineSubject(s)
Carcinoma, Medullary/genetics , Marfan Syndrome/genetics , Mouth Mucosa , Mouth Neoplasms/genetics , Neuroma/genetics , Pheochromocytoma/genetics , Thyroid Neoplasms/genetics , Carcinoma, Medullary/diagnosis , Child , Chromosome Aberrations , Craniofacial Abnormalities/diagnosis , Craniofacial Abnormalities/genetics , Facies , Female , Genes, Dominant , Humans , Marfan Syndrome/diagnosis , Mouth Neoplasms/diagnosis , Neuroma/diagnosis , Pheochromocytoma/diagnosis , Precancerous Conditions/diagnosis , Precancerous Conditions/genetics , Thyroid Neoplasms/diagnosisABSTRACT
A case of antero-septal myocardial infarction in a child of 13, presenting as syncopal attacks, is reported. Selective coronary angiography showed severe diffuse lesions of the anterior descending artery and the right coronary artery. Clinical progress was satisfactory over an 18 month follow-up period. The only biochemical abnormality was a raised serum uric acid, the significance of which is discussed.
