Clinical Pediatrics

The field of delayed hypersensitivity continues to grow in complexity. One expects that increasing understanding of cell-mediated responses in clinical immunology will lead to greater advances in this field. This review explains and summarizes the pertinent newer concepts of clinical promise.

The complications of acute asthma in childhood include atelectasis with or without pneumonia, mucoid impaction of the bronchi, subcutaneous emphysema and pneumomediastinum, spontaneous pneumothorax, bronchiectasis, and allergic bronchopulmonary aspergillosis. The incidence, pathogenesis, clinical attributes, roentgenographic manifestations, and therapy of these complications have been described briefly and illustrative case histories and roentgenograms taken from the records of the Children's Hospital of Philadelphia have been set forth. The clinician's reliance upon the radiologist for precise diagnosis in these cases becomes apparent as each complication is examined separately, underscoring the desirability of obtaining a chest film routinely when severe acute asthma presents a problem in management.

A study of dietary intakes of calories, protein, fat, carbohydrate and iron, along with determinations of hemogram, serum iron, iron binding capacity, transferrin, transferrin saturation and plasma proteins, was done on 26 Day Care children and 15 non-Day Care controls, aged 7 to 32 months, all registered in a Children and Youth health care program. Significant differences favoring the Day Care children were limited to HGB and HCT in the older children, and HGB, HCT, MCV, MCH, transferrin, and iron binding capacity in the younger children. Daily intakes calculated from nutritional history obtained from the parent or observed in the Day Care unit showed average iron intake low in all children. As a result of these findings, it is suggested that children under two years of age be afforded preference over older children when spaces are available in Day Care Centers, and that the dietary intakes of these children be examined carefully to ensure that they are receiving optimal nutrients.