David L. Silber

Henoch-Schoenlein syndrome.

No specific hematologic defect has so far been found in this disorder, but its many similarities to blood diseases suggest that there is one. Treatment is mainly supportive, unless there is concomitant bacterial infection (which is often the case).

Encopresis Discussion of Etiology and Management

The child with fecal incontinence tends to be resented by his parents, ostracized by his peers, condemned by his teacher, and is frustrating to his physician. There have been numerous studies of this subject in recent years, but information and practical suggestions on therapy are not readily available to the practitioner.The child with fecal incontinence tends to be resented by his parents, ostracized by his peers, condemned by his teacher, and is frustrating to his physician. There have been numerous studies of this subject in recent years, but information and practical suggestions on therapy are not readily available to the practitioner.

Gastrointestinal histoplasmosis in children

Abstract Three children with documented gastrointestinal histoplasmosis are presented and the pertinent literature reviewed. One of the patients had coexistent active histoplasmosis and coccidiomycosis. In each case operation was necessary for management of emergent complications. In two of the patients, the enteritis resembled Crohns disease both grossly and radiographically. These cases demonstrate the need for considering histoplasmosis as a cause of abdominal complaints, especially in endemic areas. They also document the effectiveness of Amphotericin B in treatment of gastrointestinal histoplasmosis.

Analysis of a straight pediatric internship.

Detailed records of all patient contacts in one individuals straight pediatric internship were kept. Analysis of the data showed a greater exposure to acute disease and commonplace problems than was expected. Examination of the interns degree of involvement (responsibility) and independent study showed little difference between inpatients and outpatients or between new and “inherited” patients.

The neurologist and the physically abused child

PROBLEMS ASSOCIATED with craniocerebral trauma in infants and children are an important segment of the activities of the practicing neurologist and neurosurgeon. The complexities of the diagnostic and therapeutic aspects of these problems are sufficiently taxing that possible social implications may be relegated to a consideration of low priority. Yet, in recent years, it has become evident that many infants with skull fractures, subarachnoid hemorrhage, or subdural hematomas have received their injuries by impulsive or premeditated abuse from someone in the home environment. Battered children commonly have head trauma of one sort or another, but visceral injuries; bruises, bites, or cigarette burns of the skin; and skeletal injuries may also occur. Abuse of a physical nature may accompany nutritional neglect in some children. In others, severe growth failure in infancy due to willful and negligent feeding habits without evidence of physical injury represents an alternative form of child abuse. As a group, neurologists tend to analyze diagnostic problems in a highly critical way requiring reasonable proof as to site and type of disease. Yet, like physicians in all specialities, they often accept without suspicion the historical information or explanation surrounding the events of cranial trauma in small children. That such information may be inaccurate and misleading is apparent from the following case reports. These cases were picked as examples from a much larger series of battered children we have seen in recent years. The first five cases experienced head trauma as the most overt aspect of their injuries. The last case had no evidence of trauma of a physical nature but illustrates, for perspective, maternal abuse of an equally important but different nature.