Ocular Presentation of Sarcoidosis in ChildrenKataria, Sudesh; Trevathan, G. Earl; Holland, James E.; Kataria, Yash P.
doi: 10.1177/000992288302201201pmid: 6627811
Ocular manifestations of sarcoidosis in children are the second most common occurrence after hilar adenopathy and pulmonary abnormalities. We present the case history of a 14-year-old black boy who presented with redness of the left eye, blurred vision, and decreased visual acuity. He was subsequently diagnosed as having sarcoidosis. All patients with uveitis or ocular findings suggestive of sarcoidosis should have a thorough medical examination and a chest x-ray. Those suspected of or proven to have sarcoidosis should have a complete ophthalmological examination. Sarcoidosis in children appears to be more frequent than previously estimated.
Incidence of Acute Rheumatic FeverSchwartz, Richard H.; Hepner, Seymour I.; Ziai, Mohsen
doi: 10.1177/000992288302201202pmid: 6627812
The incidence of acute rheumatic fever has declined remarkably in the past three decades, but the disease has not been eradicated, as some physicians believe. This study documents the diagnosis of the disease in 23 middle-class children from Fairfax County, Virginia, during the 11-year- period from 1970 through 1980. This county has one of the highest median family incomes in the United States. The annual age-adjusted incidence rate of initial attacks of acute rheumatic fever per 100,000 Fairfax County children declined from 3.0 in 1970 to 0.5 in 1980.In six of the 23 children, carditis accompanied by monarticular arthritis or arthralgia was present. Another seven children had carditis plus polyarthritis. Two patients had Sydenham's chorea. None of the children had erythema marginatum or rheumatoid nodules. In two children, symptoms of acute rheumatic fever developed two weeks after they finished a 10-day course of penicillin for Group A streptococcal pharyngitis. The remaining 21 children had not been considered ill enough to be brought to medical care prior to development of symptoms of acute rheumatic fever.
PKU and TemperamentSchor, David P.
doi: 10.1177/000992288302201204pmid: 6627814
Parents of children with PKU completed behavior rating forms for their children three through seven years old. The 25 completed forms represented 79 percent of the families con tacted ; 16 of the children had PKU and 9 were siblings of children with PKU. Of the 16 children with PKU, 15 were on phenylalanine-restricted diets at the time of the study. The children with PKU were rated as significantly more rhythmic, more intense, and less persistent than the siblings without PKU. When ratings were compared with those obtained from a private pedi atrics practice, children with PKU were significantly less persistent and the siblings were sig nificantly less rhythmic and less intense. There was a significant correlation between blood phenylalanine levels and persistence ratings, with children having higher blood levels tending to be rated as less persistent than children having lower blood levels.
Regional Anesthesia During Newborn CircumcisionHolve, Richard L.; Bromberger, Patricia J.; Groveman, Howard D.; Klauber, Melville R.; Dixon, Suzanne D.; Snyder, Joel M.
doi: 10.1177/000992288302201205pmid: 6354552
A controlled, double-blind investigation was undertaken to determine whether regional anesthesia by dorsal penile nerve block (DPNB) could effectively minimize the pain and behavioral disruptions usually associated with newborn circumcision. Fifteen infants had DPNB with lidocaine, eight control infants had DPNB with saline, and eight additional control infants were circumcised without undergoing DPNB. Newborn distress was gauged by subjective observation, measurement of heart rate, and the percent of time spent crying in six sequential timed intervals during cir cumcision. Ninety-three percent of subjects who received lidocaine were observed to have a decrease in agitation after anesthetic administration. The mean increase in heart rate during circumcision was at least 50 percent less in the lidocaine injected group than in either control group (p < 0.01). Infants who had DPNB with lidocaine cried 50 percent less during circumcision compared to combined controls (p < 0.01). DPNB was easily administered, and there were no significant complications. Physicians who circumcise newborns have good reason to employ the technique of dorsal penile nerve block with lidocaine to minimize infant pain and distress.