Irwin Benuck

Centrally and peripherally induced anosmia: Influences on maternal behavior in lactating female rats ☆

Abstract Bilateral removal of the olfactory bulbs was found to produce deficits in several components of the maternal behavior of lactating, primiparous female rats. More dead pups were found in the cages of bilaterally bulbectomized females shortly after parturition than in the cages of unilaterally bulbectomized, sham operated, or unoperated females. Futhermore, bilaterally bulbectomized females showed deficits in pup retrieval relative to females in the other surgical conditions, and pups reared by bilaterally bulbectomized females weighed less at weaning than pups reared by females in the other surgical conditions. In contrast to bilateral bulbecomy, zinc sulphate treatments had no influence on pup mortality at parturition. However, zinc sulphate treated females did exhibit deficits in pup retrieval relative to saline treated females.

Influences on parents’ decisions for home and automobile smoking bans in households with smokers

OBJECTIVE To understand clinician influence on use of home and automobile smoking bans in homes of children living with a smoker. METHODS Parents were surveyed on tobacco use, smoking bans, demographics and opinions about tobacco, including harm from environmental tobacco smoke (ETS). Responses from 463 diverse households with smokers were analyzed. RESULTS 42% of respondents smoked; 50% had a home smoking ban and 58% an automobile smoking ban. Nonsmokers living with a smoker, those who strongly agreed in ETS harm, and those having a child < or = 5 years more often had a home smoking ban. Those recalling their childs doctor ever asking the respondent about their smoking status and African American respondents less frequently had a home ban. Automobile smoking bans were more often held by those with strong agreement in ETS harm and less often found in families having a child receiving Medicaid/uninsured. CONCLUSIONS Having a strong perception of harm from ETS exposure was associated with having smoking bans. Aspects of health encounters not measured by this study may be negatively influencing adoption of home smoking bans or lead to recall bias. PRACTICE IMPLICATIONS Clinicians should examine the strength, focus, and response to their messages to parents about tobacco.

Usefulness of parental serum total cholesterol levels in identifying children with hypercholesterolemia

It was hypothesized that healthy children with high cholesterol levels may have parents who exceed acceptable cholesterol levels established by the National Cholesterol Education Program. One hundred sixty families (320 parents, 263 children aged 3 to 10 years) were evaluated for total cholesterol and other risk factors. Before the study, almost half of the parents had not had serum total cholesterol measured. The odds ratio for a child having a total cholesterol greater than or equal to 5.17 mmol/liter (200 mg/dl) was 13.6:1 (confidence interval 5.7 to 32.5) for a child with at least 1 parent having cholesterol greater than or equal to 6.20 mmol/liter (240 mg/dl) versus a child whose parents had low total cholesterol. Testing only children who had at least 1 parent with a total cholesterol greater than or equal to 5.17 mmol/liter (200 mg/dl) had a sensitivity of 98% for detecting childrens total cholesterol greater than or equal to 5.17 mmol/liter. It is concluded that parental total cholesterol is useful in identifying children with high total cholesterol levels. Pediatricians may identify a large number of parents with hypercholesterolemia not previously recognized.

Physicians’ Lack of Adherence to National Heart, Lung, and Blood Institute Guidelines for Pediatric Lipid Screening

Objectives. To determine adherence to the 2011 National Heart, Lung, and Blood Institute lipid screening guidelines and identify patient factors promoting screening. Methods. Records of children who received well-child care at age 11 years and turned 12 in 2013 were reviewed. Subjects were stratified by guideline-defined dyslipidemia risk based on documented medical or family history risk factors. We defined adherence as the order of a lipid profile when age 11 years or completed lipid screening at 9 to 10 years. Results Of 298 subjects, 42% were assigned to the dyslipidemia high-risk subgroup. Records of 27.2% demonstrated adherence. Fifty-six percent of high-risk subjects versus 6% of their non-high-risk counterparts received lipid screening by age 12 (P < .001). Among screened subjects, history of obesity and parental history of dyslipidemia were significantly associated with lipid testing. Conclusions. Lipid screening rates were low. Strategies to increase lipid screening in the primary care setting are needed.

Tobacco, Heart Disease, and Practical Counseling

As a large part of the care for children is preventive health, knowledge about the effects of tobacco exposure, risk factors, prevention strategies, and intervention are important. Because most smokers begin smoking while being cared for by physicians who care for children, pediatricians are particularly well suited to identify those at risk and to provide meaningful prevention. As physicians, we need to also assist parents to quit smoking, thereby setting a good example to their children, while improving their health as well as that of their children. Likewise, when identifying a youth experimenting or regularly smoking tobacco, intervention needs to be offered through counseling, referral, or medical therapy.

Strategies and suggestions for a healthy toddler diet.

Nutritional challenges for toddlers are common because their eating behaviors are inconsistent; they may eat more or less than requirements meal to meal and day to day. To help reduce parental stress, its essential to discuss with parents/caregivers their expectations on how and what they think their toddler should be eating. It is important to remember that toddlers are not little adults; portion sizes are often distorted (too large), and portions should reflect the individual childs age and development. Parents/caregivers can help with new food acceptance by modeling good mealtime behaviors such as limiting high-energy, low-nutritional food and drinks, eating healthy foods along with their children together at the table with the television shut off, and eating appropriate portion sizes. Pediatricians should inform concerned parents/caregivers that toddlers commonly do not accept new foods; foods may need to be introduced repeatedly, up to 10 to 15 times before a child will eat them. To adhere to National Heart, Lung, and Blood Institute (NHLBI) guidelines, parents and caregivers should focus on providing balanced meals that offer a variety of foods, with at least three to four food groups for meals and one to two food groups for snacks, always including familiar foods along with new foods. It is important to reassure families that adherence to NHLBI guidelines for toddlers may be difficult at first, but with the proper education, planning ahead for meal/snack times, and education of all providers caring for the toddler (including nannies, daycares, and family members), it can be done successfully. Improving the nutrition and health of their young toddler will help prevent risk factors for the development of cardiovascular disease.

Sudden death in a neonate as a result of herpes simplex infection.

This paper describes a case of a neonate with disseminated herpes simplex born to a 14-year-old asymptomatic mother. The infants physical examination was normal at birth, and subsequent abnormalities were so subtle that infection was not recognized during life. Postmortem cultures of liver and spleen grew herpes simplex virus, and immunofluorescent direct antibody typing revealed Type 2. A cervical culture of the mother obtained after the infants death was negative.

Malignant external otitis in a diabetic adolescent.

Malignant external otitis (MEO) is an unusual medical problem. The case reported is that of a diabetic adolescent who presented with severe ear pain unresponsive to oral antibiotics and analgesics. The diagnosis of MEO was made, and he was successfully treated with a combination of intravenous anti-Pseudomonas agents. A review of the pediatric cases, guidelines for diagnosis, length of treatment, and prognosis are presented.

A Pediatric Practice's Journey to Provide Care to "Healthy Babies and Children"

In 1923, Dr. Alfred Traisman literally hung out his shingle on the corner of Clark Street and Arthur Avenue in the East Rogers Park neighborhood of Chicago, IL, and thus began over 90 years of our practice-providing care to pediatric patients in the Chicagoland area. We have witnessed many changes since those early days but what has stayed consistent is the continuity of care, the focus on the patient, and our office as the medical home. The practice has 3 generations of Traisman pediatricians and some families can actually be traced back 5 generations.

Universal lipid screening: Response regarding implications for primary care practice

The Expert Panel guidelines for cardiovascular health and risk reduction in childhood,1 commissioned by the National Heart, Lung, and Blood Institute, are a valuable resource for pediatric care providers, addressing the major risk factors associated with development of atherosclerosis. Endorsed by the American Academy of Pediatrics, the recommendations correspond with the age and developmental stages in Bright Futures2 so they can be incorporated into routine health maintenance. The recommendations are presented with a summary of the evidence, allowing clinicians to apply their own knowledge and experience in deciding what is necessary for each child and family. The Expert Panel was selected to include representatives from pediatrics, family medicine, cardiology, nutrition, and nursing. Each brought their expertise to evaluation of the evidence and recommendations that can be readily integrated into …