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Pediatrics 1981 Sobel 753 4
Pediatrics 1981 Sobel 753 4
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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007. Copyright 1981 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
the
first
variable
in
that
the
control
group
received
nurs-
ery care
niques.
were point
aware of the treatment out that parents may experimental program nursery
this not to nurse or the this knew whether authors was their experimental enriched. could If this have obtained, child was would matter
introduced some variation in that the lies, having observed the intervention nursery, after
enced practical
Scale while their infants were receiving intermediate convalescent care in the nursery and administration the Bayley Scales of Infant Development, growth surements, and physical examinations at six months expected date of confinement.
The prethat and postassessments were studies using administered
and of
meapast by a
may the
short-term
have
modeled observed
results. in that
their
Actually it would
subsequent
behavior and
have
caretaking
importance
in the
influlittle
licensed
We uators would agree
child
who are be highly
clinical
subsequent unaware desirable. of the Scales
psychologist,
of experimental However, author Scales
who
was
not
blind.
evalstatus follow-
whether
improved
parental
tential
development
observation variable not of
was
the mentioned
due
by
intervention,
informed
not whether receiving knew parents their
consent.
control special infants expectations
They
indicate parents
care were
or
in administering To minimize
being and
perceptions
their
influenced
relationship
the
with
outcome
their
in
infants
the
and importance
this
of
might
the
have
results.
a reliability check was obtained by two observers, one whom was a licensed clinical psychologist with experience with the Bayley Scales, and the other, a graduate
direction
would probably
have
not
more
persist
practical
after the
because
program
it
enrichment
standard.
greatest importance is the necessity for absolute
Of
The
again
objectivity
Bayley
in measuring
motor six authors, experimental of assignment infant it is doubtful could remain and months and
outcome
developmental following since subjects, in has that objective, each control
for behavioral
testing nursery subjects this case. author The
research.
was discharge were would Bayley tested have test cominvested of intendone by
approximately
one of the the aware a 6-month-old and months
before
been
comments
for
ponent, ten
a definite anyone
irrespective
Department Childrens
281 Locust Akron, OH
of Pediatric
Hospital St
44308
Medical
of Akron
tions
blind,
or
and
intellectual
if not,
honesty.
subsequent
Hopefully
studies of
the
this
tester
type
was
should
utilize
status.
data
collectors
unaware
WILLIAM A.
of experimental
ALTEMEIER
vs control
III, MD
Center
On Angiomas
of early Pediatrics interven66:83, To the Editor.-
of Retina,
Brain,
and
Skin
Benfield stimulation
Recently Russell et al (Pediatrics 66:306, scribed a child with a hemangioma of the right forehead and right upper eyelid, an arteriovenous
Dr
to respond
1980)
de-
side
of the
malfor-
We
and
appreciate
like
Altemeiers
to the
interest
issues he
in our
has raised.
would
As control
stated group
in the study,
receiving that time. written
paper, standard
the Parents consent
during intensive
prescribed of the for
basal ganglia and suprasellar angiomatous ocular lesion, hormone deficiency. They were syndrome. consistent It is our
vascular
region, and who had an concluded that with a variant that opinion
to were
gave
malformations
all infants
no dures their infants at
in the
neonatal
the
Sturge-Weber
cerebral
of the
angiogram
cutaneous
illustrations
nevi
and
the
repre-
informed
their
infants
to
partic-
of Wyburn-Mason
syndnome.24
ipate
in
a
and
research
development.
to
Parents
measure
of the
their
infants
infants
in the
The
aneurysms
lateral
Wyburn-Mason
of the retina, and
syndrome
includes
arteriovenous
growth
experimental
their
group
to
informed
in a special
written
consent
for
pro-
infants
participate
enrichment
gram nurses.
in the Both
use of the
nursery, groups
following Brazelton the
was
parents
to be administered
were informed measures: Behavior
by the
that administraAssessment we
The photograph of the although rotated 90 degrees the signal fmding of the
racemose angioma of the
would
tion
evaluative Neonatal
increased
number
and
size
of seemingly
fully
developed
LETTERS
TO THE
EDITOR
753
tortuous riovenous
retinal
vessels
with
probable
ate-
Dietary
To the
Chloride
Editor.-
Deficiency
syndrome demonstrates choroid without retinovascular involvement ception of mildly dilated otherwise normal
The angiogram illustrated in their
entitled
(Pediatrics
The
Dietary
66:366,
Chlo1980), if
probably unilateral arteriovenous aneurysm of the bral vessels, consistent with the Wyburn-Mason drome. Intracranially the Sturge-Weber syndrome
cludes occipital leptomenigeal lobe and plane angiomatosis x-ray deep nevi are shows to the seen usually covering
the infants mentioned who believe in early dietary addition other chloride to foods their and lived
had been cared for by pediatricians feeding of infants, the problem would the
be unlikely
of In
syninthe
not infants
to
have would
occurred. be getting
such
develop
of cortical
tion of the Cutaneous
calcifications
meninges.6 vascular
deficiency.
Having mula, the me that feeding, the problems of diarrhea due to forin to
oversteriization
seizures formula, when solid and and
Weber
like
would vas-
cular nevi, ocular vascular abnormalities, and cerebral vascular malformations are seen in clinical syndromes other than Sturge-Weber. These syndromes include Wyburn-Mason,2 Von Hippel-Landau,7 Gass,8 and Osler-Weber-Rendu.9 and
of
child is finishing can be introduced. caloric that intake, the helps child
child
the
of adequate night,
him will
sleep through
get an adequate as a result Furthermore, of
Careful
to the
clinical
genetic
with
LOUIS JEFFREY
syndromes MS
date
accurate
differentiation. I.
SOBEL,
when the infant is young, it is easier to approach mom to put daddy on a decent diet too. Having fought milk anemia for 30 years, it is really disturbing for an old-timer like me to hear those youngsters mula in pediatrics insist the for six months. I think feeding of other foods.
BLACKMAN, PATRICIA
MD ALAN H. FRIEDMAN, MD Department of Ophthalmology Mount Sinai Medical Center 100th St and 5th Ave
ODEL,
G.
forfor
early
MD
and Child of Health Health
New REFERENCES
1. Russell JD, Wise PH, Rischbieth
York,
NY
10029
Austin,
HG: Vascular malforma-
TX
78756
A cause
of isolated
aneurysm
growth
hormone
and
retinal,
facial
naemi
and
mental
changes.
dietary
ride-deficient
first is that the early introduction foods would have prevented the occurrence of chloride deficiency in the infants ingesting chloNeo-Mull-Soy. The Table shows the age at
to two
of the
issues
raised
in Dr
Neuro-ophthalmology, ed 3. Co, 1969, pp 1693-1694 P: Bonnet-Dechaume-Blanc syndrome, in Vinken PJ, Bruyn GW (eds): Handbook of Clinical Neurology: The Phakomatoses. New York, American Elsevier Publishing Co, 1972, vol 14, pp 260-266 5. Susac JO, Smith JL, Scelfo RJ: The tomato catsup fundus in Sturge Weber syndrome. Arch Ophthalmol 92:69, 1974 6. De Recondo J, Haguenau M: Neuropathologic survey of the phacomatoses and allied disorders, in Vinken PJ, Bruyn GW (eds): Handbook ofClinicalNeurology: The Phakomatoses.
which
the introduced
solid
12 infants
foods
into
were
the
introduced
in our of seven In eight
into
paper. of
the
Solid
diet
foods solid
of
1 1 of
1 1 of the
prior TABLE.
of Solid Patient
No.
to
5 months
instances
Dietary
Foods
Soy
and
Introduction
Age at Diagnosis
Metabolic (mo) 7 Alkalosis
of
New York, American Elsevier Publishing Co, 1972, vol 14, pp 63-65 7. Grossman M, Melmon KL: Von Hippel-Landau disease, in Vinken PJ, Bruyn GW (eds): Handbook ofClinical Neurol.
ogy : The Phakomatoses. New York, American Elsevier Pub-
1
2
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7 8
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neurological disorders synopsis and differential diagnosis, in Vinken PJ, Bruyn GW (eds): Handbook ofClinical Neurology: The Phakomatoses. lishing Co, 1972, vol New 14, p 120 York, American Elsevier Pub-
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754
PEDIATRICS
Vol.
67
No.
5 May
1981
On Angiomas of Retina, Brain, and Skin Louis I. Sobel, Jeffrey G. Odel and Alan H. Friedman Pediatrics 1981;67;753
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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007. Copyright 1981 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.