It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops and newsletters, successfully bring to the attention of physi cians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, patho anatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years and over this period, neurosurgeons have ob tained special training in pediatric neurosurgery and then dedicated them selves primarily to its practice. Centers, Chairs, and educational pro grams have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's ner vous system."

This concise textbook of pediatric surgery is designed to guide the reader logically from symptoms and signs to diagnosis and treatment. Each chapter is devoted to one of 35 key symptoms and signs, which are organized according to six body regions: head, neck, chest, abdomen, urogenital system, and back. In each case, a brief assessment of the presenting sign/symptom and differential diagnosis is followed by discussion of occurrence, clinical presentation and significance, diagnostic work-up, treatment, and prognosis. Informative tables, illustrations, and up-to-date references are included throughout. Readers will also have access to an e-learning tool developed in collaboration with the Institute of Medical Education, University of Bern, which highlights the characteristics of pediatric surgical disorders and their treatment and includes clinical, radiological, and intraoperative images.

Unique collection of case and research reports on rare metabolic disorders Contains unusual or previously unrecorded features relevant to metabolic disorders All contributions rigorously peer-reviewed JIMD Reports publishes case and short research reports in the area of inherited metabolic disorders. Case reports highlight some unusual or previously unrecorded feature relevant to the disorder, or serve as an important reminder of clinical or biochemical features of a Mendelian disorder.

Nutrition in Infancy: Volume 1 is a very useful resource for all clinicians treating and preventing nutritional problems in infants. This volume covers a wide range of topics that support wellness in infants through the prevention and treatment of infectious diseases, malnutrition, and developmental and genetic abnormalities. A variety of chapters deal with nutrients for infants with disabilities, surgery, and other special needs. Special emphasis is provided for clinicians treating the millions of children in developing countries whose death is promoted by undernutrition or malnutrition. The next sections discuss the health benefits of supplementation and breast feeding and methods to improve use of berast feeding and it's duration. In Nutrition in Infancy: Volume 1, all of these facets of nutrition and nutritional therapy are covered in a precise and practical way. The latest developments in diagnostic procedures and nutritional support are also included. Written by a group of international experts, this volume is an indispensable new reference for clinicians with an interest in the nutrition and health of pregnant mothers and their infants.

Perinatal problems in thyroid gland physiology are common but complicated and present a diagnostic dilemma for the primary clinician. In December 1990, an international group of basic and clinical investigators gathered in Longboat Key, Florida to address these issues. The participants included internists, obstetricians, pedia tricians, neurologists, pathologists and basic scientists in cellular metabolism, endocrine physiology, and molecular biology. The presentations contained within this book bring together their most current and vital research related to the field of perinatal thyroidology. This book is based on the dynamic and fruitful exchange of the participants at the symposium. We are indebted to these individuals whose valuable insights and efforts are contained within this text. Barry B. Bercu Dorothy I. Shulman vii CONTENTS Session I Mechanism of Thyroid Hormone Action 1 Leslie J. DeGroot Thyroid System Ontogeny in the Sheep: A Model for Precocial Mammalian Species * . . * * 11 Delbert A. Fisher Pathologic Studies of Fetal Thyroid 27 Development * * * * * * * Douglas R. Shanklin Thyroid Hormone Control of Brain and Motor Development: Molecular, Neuroanatomical, 47 and Behavioral Studies * * * * * * * S. A. Stein, P. M. Adams, D. R. Shanklin, G. A. Mihailoff, and M. B. Palnitkar The Thyroidectomized Pregnant Rat: An Animal Model to Study Fetal Effects of Maternal Hypothyroidism 107 Susan P. Porterfield and Chester E.

Julio Morales describes the Puerto Rican nation as being comprised of those individuals who identify themselves as Puerto Ricans. This includes almost 6. 2 million people who live primarily, but not exclu sively, on the island of Puerto Rico, and in the northeastern United States. One gets to be a Puerto Rican by various means. You are Puerto Rican if you are born in Puerto Rico, although at the same time you are an American because you were born there. You are Puerto Rican if your parents are Puerto Rican, even if you have never visited the island, have never eaten arroz y habichuelas, and have never spoken a word in Spanish. You can be a second and third generation Puerto Rican of mixed marriage, be highly acculturated to American culture, but when asked, you say proudly, "I am a Puerto Rican. " You can meet some of us whose world is bicultural, a world where English and Spanish are easily interchanged, where traditional Thanksgiving turkey is followed by lechon asado at Christmas as the main treat, where salsa or bolero are enjoyed with the same passion as rock'n roll or the big band sound. It is a world where various cultures have merged and the historical forces of slavery and Spanish and American colonialism have left their indelible marks on the psyche."

This volume of "Agents and Actions Supplements" provided a challenge to the editors, the authors and the publisher. It was our aim to complete the book in advance of the lectures to be given at the "International Symposium on Asthma and Allergic Diseases in Childhood," in Berne, Switzerland, on March 25th-27th, 1993. This symposium commemorates the 10th anniversary of the Swiss Association of Parents of Asthmatic and Allergic Children. The incidence of asthma and allergies generally is on the increase and demands everyone's attention, including that of physicians, researchers, allied health professionals and parents. There have been no recent breakthroughs in our understanding of asthma pathogenesis or treatment. However, forms of treatment, pathogenetic insights and public awareness are undergoing rapid changes as our knowledge of atopic diseases increases. For this reason we chose the title "Update on Childhood Asthma." The purpose of the papers is to summarize recent research results, to provide an update on the current approach to therapeutic interventions and to alert readers to the psychosomatic aspects of asthma. Whether the state of knowledge has already changed while you are holding this book in your hands is not so much dependent on a delay in publishing but on the speed of appearance of new research results. Fortunately, our ambitious target to edit the proceedings in advance of the conference has been successful. This was only possible because of the timely submission of papers, the speed of publication and the enthusiasm of the editors.

Psychodermatology is a relatively new field in evolution and thus, there is a comparative paucity of information in general. However, when it comes to children and adolescents there is a complete vacuum of information as no other book has aimed to specifically address the psychodermatological issues facing this particular population. For assessment, diagnosis, comprehensive treatment of children with psychodermatologic conditions and establishing a relationship between skin and psyche, there is a lack of clear and relevant clinical information about these complex disorders. The complexity of these disorders is related to lack of understanding in genetic, embryonic, physiologic, neuroimmunologic, neurocutaneous, stress-related neuromodulation, and psychosomatic interconnections. This book presents a clinically relevant approach to the management of psychodermatologic issues encountered in normal practice. Various classifications and major categories that are discussed include psychophysiologic disorders, psychiatric conditions with dermatologic manifestations, dermatologic disorders predisposing to psychiatric disorders, systemic diseases with psychodermatological manifestations, and special issues in management of psychocutaneous disorders in children and adolescents.

Paediatric Biomechanics and Motor Control brings together the very latest developmental research using biomechanical measurement and analysis techniques and is the first book to focus on biomechanical aspects of child development. The book is divided into four main sections - the biological changes in children; developmental changes in muscular force production; developmental changes in the biomechanics of postural control and fundamental motor skills and finally the applications of research into paediatric biomechanics and motor control in selected clinical populations. Written by a team of leading experts in paediatric exercise science, biomechanics and motor control from the UK, the US, Australia and Europe, the book is designed to highlight the key implications of this work for scientists, educators and clinicians. Each chapter is preceded by a short overview of the relevant theoretical concepts and concludes with a summary of the practical and clinical applications in relation to the existing literature on the topic. This book is important reading for any sport or exercise scientist, health scientist, physical therapist, sports coach or clinician with an interest in child development or health.

Molecular and Cell Biology of Muscular Dystrophy gives a series of accounts of various aspects of the remarkable breakthrough which has been achieved in our understanding of the Duchenne/Becker muscular dystrophies and of the consequences and ramifications of this breakthrough.

The genesis of this book occurred several years ago provide readers with not only the "what to do" of child behavior therapy, but the "how to do it" as in Seattle on the veranda of a Chilean cafe overlook well. Each of the chapters guides the reader through ing Pikes Place Market during a National Associa tion of School Psychologists conference. We were the clinical decision-making process, from identify ing a problem to evaluating the effectiveness of a discussing, along with several other behavioral school psychologists, how the field of child behavior chosen intervention. One of the difficulties in assembling an edited analysis and therapy has experienced rapid growth over the past forty years, but lamenting that books in book is ensuring a high degree of continuity and the area did not reflect the advancements made in the similarity between chapters, without infringing on assessment and treatment of a wide variety of prob the individual writing style of the authors. This lem behaviors evidenced by children. That is not to book is certainly no exception. To help with conti say that there are no good books available to the child nuity, we provided the authors with an outline to use behavior therapist. In fact, most readers of this book as a guide as they prepared their manuscripts. The undoubtedly have bookshelves lined with noteworthy operative word here is "guide.

This atlas is a practical approach to problems commonly encountered in paediatric tumour diagnosis. It comprehensively covers a wide range of common and unusual entities. Over 300 full-colour illustrations are complemented by a text which is pragmatic and succinct. References have been carefully selected to reflect current thought and well-written reviews. New treatment strategies have led to considerable improvement in the salvage rate and prognosis in childhood neoplasia. Histological diagnosis in this area is fraught with problems and the demand invariably has been for a prompt and accurate histological reporting. The problems although wide-ranging, are particularly manifest in the area of the small round-cell tumours which constitute an important proportion of paediatric cancers. This atlas will be invaluable as a bench manual for the practising pathologist and as a study aid for the trainee. It will also be of interest to all oncologists and paediatricians.

Acute and chronic viral hepatitis infections are serious public health threats around the world. The different infections have different epidemiology and natural his- ries, and children play important roles in each of these. For example, children are important reservoirs for acute hepatitis A, childhood infections are responsible for most of the global morbidity associated with chronic hepatitis B, and perinatal transmission of hepatitis C continues to occur, even as the overall incidence of new infections wanes. Some non-A through E viral hepatitis infections are seen p- dominantly in infants and young children, while others have specific implications for this population. Therapeutic options for children with chronic viral hepatitis are limited when compared to those available for adults, especially for hepatitis B, and considerations given to long-term therapy have dramatic implications when dealing with the long life expectancy of these young patients. With these issues in mind, this unique volume has been created to address the special considerations regarding viral hepatitis in children. It includes the latest information and recommendations specifically directed at the pediatric population, and highlights the knowledge gaps which will need to be filled to improve our understanding of these infections and treatment of this special group. Experienced practitioners from around the world have contributed these reviews, incorporating the latest studies, the current recommendations, and the distinctive pediatric issues that shape clinical care, and will determine the research agenda for this field going forward.

"Resilience in Children, Adolescents, and Adults: Translating Research into Practice "recognizes the growing need to strengthen the links between theory, assessment, interventions, and outcomes to give resilience a stronger empirical base, resulting in more effective interventions and strength-enhancing practice. This comprehensive volume clarifies core constructs of resilience and links these definitions to effective assessment. Leading researchers and clinicians examine effective scales, questionnaires, and other evaluative tools as well as instructive studies on cultural considerations in resilience, resilience in the context of disaster, and age-appropriate interventions.

Key coverage addresses diverse approaches and applications in multiple areas across the lifespan. Among the subject areas covered are:

- Perceived self-efficacy and its relationship to resilience.
- Resilience and mental health promotion in the schools.
- Resilience in childhood disorders.
- Critical resources for recovering from stress.
- Diversity, ecological, and lifespan issues in resilience.
- Exploring resilience through the lens of core self-evaluation.

"Resilience in Children, Adolescents, and Adults" is an important resource for researchers, clinicians and allied professionals, and graduate students in such fields as clinical child, school, and developmental psychology, child and adolescent psychiatry, education, counseling psychology, social work, and pediatrics.

Diabetes mellitus is rapidly increasing in prevalence throughout both developed and developing countries. The social and economic burden of this disease is estimated to cost 14 billion dollars worldwide. In the USA alone, 15 million individuals are diabetic, nearly half of them unaware of their condition. Complications of diabetes mellitus are the leading causes for blindness, limb amputation and chronic renal failure and kidney transplantation in industrialized countries. Further, diabetes mellitus per se and the metabolic derangement associated with diabetes are important risk factors for cardiovascular disease. Diabetes, as defined by an elevated fasting blood glucose level is presently subdivided in etiologically distinct groups. The most prevalent being type 2 (adult onset) diabetes characterized by insulin resistance and failure of the ~-cell to supply insulin in amounts sufficient to meet the body's needs. Type 1 (juvenile) diabetes, most commonly with an onset during childhood and adolescence, is caused by an auto-immune destruction of the pancreatic ~-cells. The causations of both type 1 and type 2 diabetes involve a combination of complex genetic traits and environmental influences. A third category are the mature onset diabetes of the young (MODY). This comparatively small group of patients (-10% of diabetes) presents relative early in life "30 years of age) compared to the more common late onset type 2 diabetes.

Hemorrhage and thrombosis are major hazards for pregnant women and their newborn infants. This book is concerned with the developmental mechanisms, the diagnosis and treatment, as well as the prevention of these hemorrhagic and thrombotic disorders. The topics discussed in this volume, (1) perinatal hemorrhage in mothers and their offspring; (2) coagulation disorders complicating pregnancy; (3) neonatal intracranial hemorrhage; and, (4) vitamin K deficiency in the neonate, will help bridge the gap between basic scientists and clinicians and between the pediatri- cian and the obstetrician. Hopefully, all those concerned with preventing these disorders will be stimulated by the information and questions raised in the fol- lowing presentations. Acknowledgements We wish to thank Professors Takeshi Abe (Vice President, Teikyo University), Nobuyoshi Shinagawa (Hirosaki University), Hiroaki Soma (Tokyo Medical College), Tamotsu Miyazaki and Keisuke Sakurada (Hokkaido University) for their helpful advice. SHIGENORI SUZUKI WILLIAM E. HATHAWAY JOHN BONNAR ANTON H. SUTOR SHIGENORI SUZUKI. * 1936 in Sapporo, Japan. M.D., Uni- 'versity of Hokkaido, 1963. Lecturer, Hokkaido Univer- sity, 1974. Alexander Humboldt-Foundation Scholarship, Free University of Berlin. University of Munich, 1974- 1976. Foriner President, Japanese Society of Obstetrical, Gynecological, and Neonatal Hematology. President of International Symposium on Perinatal Thrombosis and Hemostasis (1989 Sapporo). Professor, College of Medi- cal Technology affiliated with Hokkaido University since 1983. WILLIAM E. HATHAWAY. * 1929 in Oklahoma, USA.

Pituitary adenomas account for 10-15% of all intracranial tumors and they frequently impair fertility. The development of medical and surgical therapy for such tumors has turned pregnancy into a reality for women harboring pituitary adenomas. However, gestation risks for both mother and fetus are still of concern for endocrinologists, gynecologists and pediatricians. This book intends to update knowledge on this topic, mainly regarding fertility restoration as well as gestational and post gestational management of patients with pituitary tumors.

The question about the function ofsleep remains one ofthe major challenges scientists are faced with. Wherein lies the fascination with sleep? I am convinced that it is the necessity for sleep. No one has failed to experience the overpowering urge to fall asleep after a disturbed night's sleep or after sleep was curtailed or deprived, especially when our daily activities impose restrictions on motor activity. The demand ofour body and brain to sleep challenges our understanding ofwhy this is the case, and which are the benefits ofa night ofprofound sleep. Also in animals prolongation of waking consistently increases their attempts to fall asleep. It has been stated that sleep is more necessary to animals than even food! The need for sleep and some insight into the consequences of the preceding daily waking activities on subsequent sleep was wonderfully formulated by Shakespeare in Othello: Not poppy nor mandragora, Nor all the drowsy syrups ofthe world, Shall ever medicine thee to that sweet sleep Which thou owed'st yesterday It is interesting that the most powerful single intervention which invariably influences sleep in a positive and predictable manner is the prolongation of waking. The activities which people or animals engage in during the wakefulness episode are secondary in the magnitude oftheir effects on sleep.

Research into child language development is being conducted more extensively, by more people, and in more countries throughout the world than at any point in the past. We now know more than we ever did before about the linguistic, cognitive, neurobio logical, and social capacities that children bring to their language learning task, as well as the ways in which these capacities interact with a whole range of factors present in the child's environment throughout the learning process, not least the particular character istics of the language or languages to which the child is exposed. Far from inducing a sense of complacency, this new knowledge seems instead to create an even stronger impetus to know more. This is partly because of the new and unforeseen questions it raises and partly because of competition between different theories to provide the best explanation of the phenomenon, and which in turn engender different methods of enquiry. This volume addresses many of the key issues which are currently exercising the minds of child language researchers, and which are likely to motivate research for some years to come. The chapters included here-all previously unpublished-present a great deal of new data and address a range of theoretical issues from a variety of perspectives.

Childhood obesity and its co-morbidities -- including type 2 diabetes, hypertension, dyslipidemia, sleep apnea, and fatty liver disease -- have seen striking increases in recent years. Despite a wealth of investigation, there is considerable controversy regarding the etiology of childhood obesity and the optimal approaches for prevention and treatment. Pediatric Obesity: Etiology, Pathogenesis, and Treatment addresses the controversy with a range of features that make it a unique resource for those who care for obese children and their families. Written from a perspective that is international in scope, the distinguished authors re-assess the roles of genetic and environmental factors in the pathogenesis of childhood obesity and critically review new studies of the effects of lifestyle, pharmacologic, and surgical interventions. The evidence-based approach of Pediatric Obesity: Etiology, Pathogenesis, and Treatment provides a comprehensive and invaluable guide for all healthcare providers concerned with the evaluation and care of children with nutritional and metabolic disease and with the societal implications of the obesity epidemic.

Many residency programs in primary care specialties do not provide the education in pediatric orthopedics necessary to effectively deal with the field's challenges. Here, the authors present a framework for the effective evaluation of childhood musculoskeletal problems in a practical and problem-based manner. The volume contains case studies and over 200 illustrations.

One volume-reference work with approximately 300 entries Each entry will contain 5-8 references Entries will kept under 7 pages, with limited references and cross-referenced to 5 other topics in the encyclopdia

We are most pleased to present Volume 3 of Developmental-Behavioral Disorders: Selected Topics, designed to serve as a companion for standard reference textbooks that address cogent issues in developmental pedi atrics. Periodic publications such as Selected Topics and theme-related articles, as well as continuing education programs, attempt to supple ment in a timely fashion the rapidly changing knowledge base in devel opmental-behavioral pediatrics. These media are important as forums for enhancing the quality of clinical practice, teaching skills, and re search activities. The need is critical for periodically disseminating and updating information about issues in developmental medicine, in as much as this field of study continues to expand at a meteoric pace. During the past several decades, developmental medicine has been recognized as a defined subspecialty in pediatrics. The spectrum of problems encompassed by this discipline is relatively broad and at times clinically overwhelming. The ultimate goal of preventing delays, disor ders, and/or dysfunctions from becoming chronic handicapping condi tions has, by volume per se, created clinical dilemmas for pediatric health care providers. There are numerous facets of providing efficient and effective care, which in the field of developmental-behavioral pediatrics are often exaggerated impediments to the delivery of services by pri mary health care specialists, e. g., time, clinical skills, need for inter disciplinary management, medical-legal responsibilities, financial reim bursements. These issues, as well as clinical problems, are still very much part of the information base to be disseminated to concerned pro fessionals."

Multidisciplinary and trans-cultural ...

This book provides an up-to-date review of the current state of care, treatment and prevention in child and adolescent mental health from multidisciplinary and trans-cultural perspectives. Systems of care, services and interventions in selected parts of the world are described by leading experts with a focus on

the current status of services in the respective parts of the world

the major needs and deficits in identifying mental health problems in children and adolescents (awareness and diagnosis)

the major needs in treatment, care and prevention

realistic proposals on how to improve the situation of children and adolescents who suffer from, or are at risk for, mental health problems.

In addition, the major principles and strategies of treatment and intervention are described, on an empirical basis, using a selected number of treatment approaches and treatment settings as examples.

Finally, the possibilities, strategies and limitations of early detection and prevention are reviewed with the aim of improving the living conditions of children and families in need of mental health support.

... a valuable resource for mental health workers all over the world

In most peroxisomal disorders the nervous system is severely affected which explains the clinical and community burden they represent. This is the first book to focus not only on the mutations causing these inherited illnesses, but also on mechanisms that regulate, suppress or enhance expression of genes and their products (enzymes). Indeed since the success and completion of the Human Genome Project all genes (coding DNA sequences) are known. However, of many, their function, and the role of the gene product has not been determined. An example is X-linked adrenoleukodystrophy, the most frequent peroxisomal disorder. Children are born healthy, but in more than 1 out of 3, demyelination of the brain starts unpredictably and they die in a vegetative state. The gene mutated in most families has been known for 10 years; but the true role of the encoded protein, ALDp, is still speculative; and within the same family, very severe and asymptomatic clinical histories co-exist, unexplained by the mutation.