Alexander K. C. Leung

The incidence of labial fusion in children

Abstract A retrospective study of 9070 female infants born at the Foothills Provincial Hospital was conducted to determine the incidence of labial fusion at birth. A prospective study was also conducted on 1970 female patients assessed through a paediatric outpatient clinic to determine the incidence of labial fusion in this population. None of the newborn infants had labial fusion. Thirty‐five children (1.8%) assessed at the paediatric outpatient clinic were found to have labial fusion with a peak incidence at 13–23 months of age (3.3%).

Hyponatremia in patients with nocturnal enuresis treated with DDAVP.

Treatment of nocturnal enuresis with DDAVP is associated with a low incidence of adverse effects. The only reported serious adverse effect is seizure or altered level of consciousness due to water intoxication. We reviewed 14 articles that reported data on serum sodium in patients treated with DDAVP for nocturnal enuresis and 11 articles that reported patients who developed a seizure or altered level of consciousness during treatment with DDAVP for nocturnal enuresis. Excess fluid intake was identified as a contributing factor in 6 of the 11 case reports.

Hemolytic-uremic syndrome

HUS is one of the most common causes of acute renal failure in childhood. D+ HUS is the most common form and usually follows an episode of hemorrhagic colitis due to VTEC or S. dysenteriae type 1. The SLT elaborated by these organisms is responsible for the endothelial damage that is the initial insult in the pathogenesis of the acute renal failure. Excellent supportive care is necessary to reduce the mortality and morbidity due to HUS.

Association of preauricular sinuses and renal anomalies

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.

Rabies: Epidemiology, pathogenesis, and prophylaxis

Rabies is a viralzoonosis that causes approximately 50,000 to 100,000 deaths per year worldwide. Most deaths occur in developing countries. Dogs are the major vector, especially in developing countries. The virus is usually transmitted to humans by infected saliva through the bite of a rabid animal; the incubation period averages 30 to 90 d. Hyperexcitability, autonomic dysfunction, hydrophobia, and aerophobia are characteristic of encephalitic rabies, which accounts for 80% of cases. The paralytic form is characterized by flaccid paralysis in the bitten limb, which ascends symmetrically or asymmetrically. Once symptoms develop, the disease is invariably fatal. Animal rabies can be controlled by proper induction of herd immunity, humane removal of stray animals, promotion of responsible pet ownership through education, and enactment of leash laws. Preexposure vaccination with modern cell culture vaccine is recommended for people at high risk of exposure to rabies and for travelers who spend longer than 1 mo in countries where rabies is a constant threat, or who travel in a country where immediate access to appropriate care is limited. Postexposure prophylaxis consists of prompt and thorough wound cleansing and immunization with modern cell culture vaccine, together with administration of rabies immune globulin to those individuals who have not previously received preexposure prophylaxis.

Salmon patches in Caucasian children.

Abstract: Eight hundred eight Caucasian newborn term infants (440 males, 368 females) and 1575 Caucasian children (806 males, 769 females) were examined for the presence of salmon patches. The patches were present in 43.6% of males and 43.8% of females in the immediate neonatal period. They were not detected in boys after age 6 and in girls after age 5 years. The most frequent site was the nape, followed by the glabellum, eyelids, nose, and upper lip.

Secondary Nocturnal Enuresis

Secondary nocturnal enuresis accounts for about one quarter of patients with bedwetting. Although a psychological cause is responsible in some children, various other causes are possible and should be considered. This article reviews the epidemiology, psychological and social impact, causes, investigation, management, and prognosis of secondary nocturnal enuresis.

The absence of anti-neutrophil cytoplasmic antibodies in patients with Henoch-Schönlein purpura

Sera from 14 patients with acute Henoch-Schönlein purpura (HSP) and 5 patients with a past history of HSP were assessed using a immunofluorescence technique for the presence of IgG, IgA, and IgM anti-neutrophil cytoplasmic antibodies (ANCA). There was no evidence of IgG, IgA, or IgM ANCA in the sera of these patients. These results suggest that ANCA are not involved in the pathogenesis of HSP.

Hemorrhagic Bullous Lesions in a Child with Henoch‐Schönlein Purpura

Abstract:  An 8‐year‐old boy with Henoch–Schönlein purpura who developed hemorrhagic bullae is described. The occurrence of hemorrhagic bullae in children with Henoch–Schönlein purpura is rare. A perusal of the literature revealed but seven occurrences to which we add another one.

Extensive Mongolian Spots with Involvement of the Scalp

Abstract: A Chinese infant boy had extensive Mongolian spots in the occipital, gluteal, sacrococcygeal, and lumbar areas. The occurrence of a Mongolian spot in the scalp area has not been previously reported. Awareness of such an occurrence is important so that a false accusation of child abuse is not made.