Abstract：
:The stress response in humans commonly includes elevations in plasma concentrations of glucocorticoids, catecholamines, glucagon, growth hormone, aldosterone, and renin, resulting in alterations in the metabolism of glucose and other energy substrates, and in increased sodium and water retention. In severe illness, triiodothyronine and sometimes thyroxine are decreased without evidence of clinical hypothyroidism. Antidiuretic hormone may be elevated in bacterial meningitis and other central nervous system disorders, as well as in acute asthma, chronic ventilator therapy, pneumothorax, atelectasis, and postoperatively. Increased ADH concentration can lead to significant hypoosmolality and hyponatremia with adverse effects on the patient. In the setting of severe intracerebral insults, ADH may be inappropriately low, resulting in diabetes insipidus. Insulin concentrations may be inappropriately low for serum glucose concentration, or insulin may have diminished receptor responsiveness in seriously stressed patients. Either situation leads to hyperglycemia. Disturbances in calcium, phosphorus, and magnesium homeostasis may occur relatively frequently in the critically ill patient in response to therapeutic interventions, or illness-induced altered metabolism. It is not always clear when an altered metabolic or hormonal state is an appropriate response to a stress, or represents decompensation of the body's mechanisms for coping with that stress. It is important, however to recognize the common responses of the organism to severe illness, and to monitor for treatable abnormalities which occur.
journal_name
Pediatr Clin North Amjournal_title
Pediatric clinics of North Americaauthors
Weise K,Zaritsky Adoi
10.1016/s0031-3955(16)36185-5subject
Has Abstractpub_date
1987-02-01 00:00:00pages
119-30issue
1eissn
0031-3955issn
1557-8240pii
S0031-3955(16)36185-5journal_volume
34pub_type
杂志文章,评审abstract：:This article discusses various anomalies and abnormalities of the umbilical cord and issues related to cord care. The issue of screening newborns with an isolated single umbilical artery for renal abnormalities is addressed. The clinical presentation of infants with omphalomesenteric and urachal duct remants along wit...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2004.01.010
更新日期：2004-06-01 00:00:00
abstract：:Acute cerebrovascular injury in term and preterm infants is a cause of significant morbidity. Treatment efforts in the past have focused on attempts to prevent such injury by interceding during labor in term infants and improving neonatal care in preterm infants. Epidemiologic studies suggest that these strategies hav...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(16)38368-7
更新日期：1992-08-01 00:00:00
abstract：:Traumatic injuries represent the most important threat to the health of children in the United States and are the leading cause of death after the first year of life. More than 20,000 children and young adults will die this year as a result of injury. For every child that dies, another 40 will require hospitalization ...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章
doi：10.1016/s0031-3955(05)70049-3
更新日期：1998-08-01 00:00:00
abstract：:Herpes simplex encephalitis (HSE) is an uncommon disease, yet 25 to 30 per cent of cases involve children. The initial clinical findings are nonspecific (fever, altered mental status), but most cases evolve to demonstrate focal neurologic signs and symptoms. The CSF is abnormal in over 90 per cent of cases. The EEG, C...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(16)36466-5
更新日期：1988-06-01 00:00:00
abstract：:The author discusses his experience with the flexible bronchoscope, covering current instrumentation, techniques, and indications and contraindications, showing that, when used carefully by a well-trained physician, the flexible bronchoscope is a safe, relatively simple, and effective tool for exploration of the pedia...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章
doi：10.1016/s0031-3955(16)34645-4
更新日期：1984-08-01 00:00:00
abstract：:When a child presents with high-anion gap metabolic acidosis, the pediatrician can proceed with confidence by recalling some basic principles. Defects of organic acid, pyruvate, and ketone body metabolism that present with acute acidosis are reviewed. Flowcharts for identifying the underlying cause and initiating life...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2017.11.003
更新日期：2018-04-01 00:00:00
abstract：:Acutely poisoned children remain a common problem facing pediatricians working in acute care medicine in the United States and worldwide. The management of such children continues to be challenging, and their care has evolved throughout the years. The concept of gastric decontamination in acute poisoning has significa...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2008.02.010
更新日期：2008-06-01 00:00:00
abstract：:In the clinical arena of transplantation, tolerance remains, for the most part, a concept rather than a reality. Although modern immunosuppression regimens have effectively handled acute rejection, nearly all organs except the liver commonly suffer chronic immunologic damage that impairs organ function, threatening pa...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2010.01.015
更新日期：2010-04-01 00:00:00
abstract：:Lack of success in achieving considerable reductions in neonatal mortality is a contributory factor in failing to achieve Millennium Development Goal 4.2.6 million neonates still die each year, with preterm birth and infections the two leading causes. Maternal infections and environmental and infant factors influence ...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2017.03.008
更新日期：2017-08-01 00:00:00
abstract：:Important first steps have been taken towards establishing how some nutrients interact with genes and affect intestinal adaptation. These mechanisms may be typical of how other nutrients influence cell function and turnover and help to maintain intestinal integrity. The dietary effects of nucleotides on intestinal cel...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(05)70415-6
更新日期：1996-04-01 00:00:00
abstract：:Tics in children and adolescents are a common occurrence; however, a small proportion of these disorders require pharmacologic interventions. Several limitations exist with the use of pharmacologic interventions, and hence, a more ideal multidisciplinary approach is recommenced, with emphasis on nonpharmacologic manag...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2010.10.004
更新日期：2011-02-01 00:00:00
abstract：:Feeding problems in infants and young children are common. In healthy children who are developing and growing normally, feeding problems are usually not serious and can be managed conservatively by reassuring the family and providing them with anticipatory guidance and follow-up. A majority of serious childhood feedin...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2017.08.021
更新日期：2018-02-01 00:00:00
abstract：:Modern assessment of the tonsils and adenoids is based on an appreciation of new concepts pertaining to the pathogenesis of tonsil and adenoid disease. Recognition of the emergence of beta-lactamase-producing and encapsulated anaerobic bacteria in the tonsils and adenoids should lead to a reconsideration of present th...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(16)36806-7
更新日期：1989-12-01 00:00:00
abstract：:Pediatric obesity is a major public health threat. Obese children and adolescents are at increased risk for many medical and surgical conditions. These conditions may affect their quality of life and life expectancy. The rapidly progressive nature of type 2 diabetes mellitus within the first 5 years of obesity diagnos...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2011.09.013
更新日期：2011-12-01 00:00:00
abstract：:Allogeneic hematopoietic stem cell transplantation from siblings, unrelated donors or HLA mismatched family members has become an important procedure to offer a chance of cure to children and adolescents with acute leukemia at high risk of relapse and those with certain genetic diseases. Bone marrow (BM) was the only ...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2010.01.004
更新日期：2010-02-01 00:00:00
abstract：:Children who have a dental home are more likely to receive preventative care, require fewer dental treatments, and are less likely to have dental disease. Many children demonstrate behavior management concerns that may impede families from establishing a dental home for their children. Conceptually, behavior concerns ...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2020.02.006
更新日期：2020-06-01 00:00:00
abstract：:Pediatric patients with ostomies are a challenge to health care providers. An ostomy is not without problems. Knowledge of surgical techniques and a commitment to the care and management of the stoma and appliances are needed to prevent and manage complications. Ongoing patient education is paramount for compliance an...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(05)70097-3
更新日期：1998-12-01 00:00:00
abstract：:Careful clinical examination remains the primary and most important way of diagnosing developmental dysplasia of the hip (DDH) in newborn infants. Repeated examinations during the first year are important to diagnose DDH subsequent to the newborn period. Sonography can detect cases of clinically silent DDH. Targeting ...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(05)70495-8
更新日期：1997-06-01 00:00:00
abstract：:Sleep problems are common in many pediatric medical disorders and complicate management and patient outcomes. A wide range of conditions, including asthma, cystic fibrosis, sickle cell disease, gastroesophageal reflux, neuromuscular diseases, scoliosis, craniofacial abnormalities, obesity, and chromosomal disorders, h...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(03)00185-8
更新日期：2004-02-01 00:00:00
abstract：:ADDs can occur as primary genetic disorders or may develop secondary to various other conditions, including infections, trauma, malnutrition, and protein-losing states. Although antibiotics are the first-line therapy for acute infection, using them prophylactically can select for resistant organisms. IM ISG and fresh ...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(05)70275-3
更新日期：2000-12-01 00:00:00
abstract：:Pediatricians, as well as other health care professionals, must always consider psychoactive drug use by adolescents as possible causes of general health or emotional problems, such as poor appetite, insomnia, problem behavior, academic underachievement, and loss of energy and motivation. Early diagnosis and intervent...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(16)36227-7
更新日期：1987-04-01 00:00:00
abstract：:Ample evidence shows that what was formerly called "juvenile rheumatoid arthritis" is not a single disease. At least six separate diseases were included as subgroups or subtypes of juvenile rheumatoid arthritis in other classifications. The clinical and laboratory features that differentiate these diseases are discuss...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(16)40057-x
更新日期：1995-10-01 00:00:00
abstract：:This article describes developments in pain assessment in critically ill neonates and infants during the last 5 to 6 years. Pain assessment instruments show a redundancy of items and a lack of profound psychometric background. Although most research focuses primarily on acute pain, in clinical practice there is also t...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2012.07.012
更新日期：2012-10-01 00:00:00
abstract：:Intestinal failure (IF) is the ultimate malabsorption state, with multiple causes, requiring long-term therapy with enteral or intravenous fluids and nutrient supplements. The primary goal during management of children with potentially reversible IF is to promote intestinal autonomy while supporting normal growth, nut...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2009.07.005
更新日期：2009-10-01 00:00:00
abstract：:The presence of certain medical or orthopedic conditions need not preclude adolescents from being physically active and participating in sports. The benefits of continued physical activity far outweigh any concerns for potential complications for most such conditions. This article reviews sport participation guideline...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章
doi：10.1016/j.pcl.2010.03.005
更新日期：2010-06-01 00:00:00
abstract：:Acne is the most common skin disorder affecting adolescents. Although no cure exists for acne, most patients benefit from currently available medications, and most can be managed effectively by their primary care providers. By offering this care, pediatricians can reduce the emotional burden of acne and help to preven...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(05)70243-1
更新日期：2000-08-01 00:00:00
abstract：:The diagnosis of a parasitic infection depends upon demonstration of the organism in stool, blood, or tissue specimens, and a variety of relatively simple procedures is available for this purpose. In this article, the author describes those procedures that are most frequently used on a routine basis. ...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章
doi：10.1016/s0031-3955(16)34868-4
更新日期：1985-08-01 00:00:00
abstract：:Neonatal resuscitation is an attempt to facilitate the dynamic transition from fetal to neonatal physiology. This article outlines the current practices in delivery room management of the neonate. Developments in cardiopulmonary resuscitation techniques for term and preterm infants and advances in the areas of cerebra...
journal_title：Pediatric clinics of North America
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.pcl.2009.03.003
更新日期：2009-06-01 00:00:00
abstract：:The overweight and obesity epidemic among children and adolescents in the United States continues to worsen, with notable racial, ethnic, and socioeconomic disparities. Risk factors for pediatric obesity include genetics; environmental and neighborhood factors; increased intake of sugar-sweetened beverages (SSBs), fas...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.pcl.2015.05.013
更新日期：2015-10-01 00:00:00
abstract：:Most ocular and orbital tumors of childhood are distinct from tumors that occur in adults. Many are congenital with early presentations. Most pediatric orbital tumors are benign; developmental cysts comprise half of orbital cases, with capillary hemangioma being the second most common orbital tumor. The most common or...
journal_title：Pediatric clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0031-3955(02)00115-3
更新日期：2003-02-01 00:00:00
