Clinical Pediatrics

Simard, P.L.; Naccache, H.; Lachapelle, D.; Brodeur, J.M.

doi: 10.1177/000992289103001101pmid: 1747975

The increase of dental fluorosis is largely imputable to the ingestion of dietary fluoride supplements and fluoride toothpastes. However, the toothbrushing habits of very young children is poorly documented. The purpose of this pilot study was to determine the toothbrushing habits of 12- to 24-month-old children and to estimate the quantity of fluoride ingested during toothbrushing. Fifty-nine parents completed a questionnaire regarding the toothcleaning habits of their children. When a dentifrice was used, a dental hygienist scheduled a meeting with the parents in order to observe and measure the amount of toothpaste used. Of the 36 parents who cleaned the teeth of their children, 69% used a toothpaste. Furthermore 20% of the children ingested more than 0.25 mg of fluoride per day by toothbrushing alone. Therefore the practice of toothbrushing and the use of fluoridated dentifrices are widespread among 12- to 24-month old children, and the amount of fluoride ingested from toothpaste could constitute a substantial proportion of the total daily intake of fluoride. Several measures are suggested to enhance the safe use of fluoride dentifrices.

Friedman, Deborah M.; Madrid, Mary; Berenstein, Alejandro; In Sup Choi, ; Wisoff, Jeffrey H.

doi: 10.1177/000992289103001102pmid: 1747976

A multidisciplinary team approach using a staged transcatheter embolization and neurosurgical protocol was applied to 22 patients with neonatal presentation of vein of Galen malformations over a 12 year period. Aggressive medical therapy was combined with interventions including: ventricular shunting, transcatheter embolization, retrograde transtorcular embolization, and neurosurgical obliteration. There was a high frequency of high output cardiac failure, multiple organ system dysfunction, seizures, hydrocephalus, visual, developmental and neurological disability. Of the first 11 patients, five survived; four with seizures and three with marked retardation. Of the last 11 patients, six survived; five with seizures but only one with retardation. Despite persistently high morbidity and mortality, our continuously evolving protocol offers these otherwise hopeless patients some chance of survival.

Nirenberg, Sheryl A.

doi: 10.1177/000992289103001103pmid: 1747977

Laughter is a partly involuntary act involving complex pathways in the central nervous system. Laughter normally has positive effects on emotions; however, pathologic laughter is not related to emotion and occurs independent of a stimulus in the environment. This paper outlines normal laughter and the etiology of pathologic laughter, considering both congenital and acquired causes.

Leung, Alexander K.C.; Robson, Wm. Lane M.; Halperin, Mitchell L.

doi: 10.1177/000992289103001104pmid: 1747978

Polyuria may result from either a water or a solute diuresis. Although the history and physical examination may provide clues to the cause of the polyuria, the definitive diagnosis requires laboratory tests which focus on the osmolality of the urine and serum in combination with the urine volume and the rate of excretion of osmoles. An isoosmolar or hyperosmolar urine is found in children with a solute diuresis or in normal children, whereas a hypoosmolar urine is found in children with a water diuresis. In the latter case, a low serum osmolality suggests primary polydipsia whereas a high serum osmolality suggests antidiuretic hormone (ADH) deficiency or insensitivity. A water deprivation test is necessary when the initial evaluation fails to establish the cause of polyuria. A vasopressin test enables the differentiation between neurogenic and nephrogenic diabetes insipidus (DI).

Botkin, Jeffrey R.

doi: 10.1177/000992289103001105pmid: 11642936

Silber, Tomas Jose

doi: 10.1177/000992289103001106pmid: 1747979

Carl Cooley, W.; Graham, John M.; Myer, Charles M.

doi: 10.1177/000992289103001107pmid: N/A

Berlin, C.M.

doi: 10.1177/000992289103001108pmid: N/A

Wildin, Susan R.; Rouse, Bobbye M.

doi: 10.1177/000992289103001109pmid: N/A