Tibial fractures of young children

Tibial fractures are relatively frequent injuries of young children. These fractures are occasionally the cause of a childhood gait disturbance. Additionally, tibial fractures may be the result of child abuse. Consequently, the pediatrician should have knowledge concerning these injuries. In this paper, we present a review of tibial fractures in hospitalized children and describe their associations with nonaccidental trauma (NAT). Finally, we provide suggestions for improving nonmenclature clarity for isolated spiral fractures of the tibia.     

Management of infants and young children with fever without source

There is considerable variation in the clinical management of infants and children with FWS. Community pediatricians generally do not follow clinical practice guidelines that are taught and used at academic training institutions. These guidelines are presented in Sidebar 1 (see page 677) and Sidebar 2. In general, the guidelines provided that all febrile neonates (>38.0 degrees C) should have a "full sepsis evaluation", including lumbar puncture, and be admitted for parenteral antibiotic therapy. Non-toxic appearing infants 29-90 days of age with FWS >38.0 degrees C can be managed using low risk laboratory and clinical criteria. Non-toxic appearing infants >90 days of age who have received Hib and PCV-7 vaccines are at low risk for occult bacteremia and meningitis. Therefore, the only laboratory tests necessary in this age group with FWS >39.0 degrees C are a urinalysis and urine culture for circumcised males <6 months of age and uncircumcised males and females <24 months of age.     

婴幼儿腹泻相关腺病毒的基因型研究

目的 探讨婴幼儿腹泻患者腺病毒 （AdV） 的分布情况及基因型特点。方法 选取3岁以下腹泻患儿380例,提取粪便基因组DNA进行腺病毒PCR检测,并对检测阳性的进行克隆测序和基因型分析。结果 在380例样本中,共检出24例腺病毒,检出率为6.3% （24/380）。阳性病例中以2~3岁患儿为主。阳性标本病毒序列分析显示,肠道腺病毒41型检出率为4.2% （16/380）,非肠道腺病毒检出率为2.1% （8/380）：其中AdV1型2例,AdV2型2例,AdV7型1例,AdV12型2例,AdV31型1例。结论 婴幼儿腺病毒腹泻常见于2~3岁的婴幼儿,AdV41是主要流行优势株。