Sniffing of volatile organic solvents containing toluene, such as acrylic paints, glues, adhesives, paint thinners, varnishes and shoe polishes, has become increasingly frequent in recent years. Renal tubular acidosis is one of a number of human complications reported in the offspring of mothers inhaling toluene during pregnancy. This article reports a case of a premature newborn with renal tubular acidosis probably due to maternal sniffing of paint containing toluene. Characteristics of this condition are described as well as its medical management. With increasing frequency of maternal glue and paint sniffing, more cases of newborn renal tubular acidosis will likely appear. Physicians should be prepared to manage neonatal tubular acidosis that may accompany maternal toluene sniffing in order to lessen newborn morbidity and/or mortality.
We read with interest the American Academy of Pediatrics' recommendation concerning dispensing of medications by physicians (Pediatrics. 1989;83:143-144). In 1987, dispensing of prepackaged prescriptions was a consideration at the Pocatello Children & Adolescent Clinic. A pharmacy that shared the same building as the clinic had closed in 1982. Despite the loss of the pharmacy, the need for patient convenience in obtaining medications continued. The decision was made not to purchase prepackaged prescriptions for dispensing by physicians. Instead, a community pharmacy (Future Generation Pharmacy) owned by the pediatricians was constructed.
To the Editor.— We recently cared for a young patient who had a rather unusual infection. Review of the standard pediatric literature and a Medline search yielded no other descriptions of this particular entity. Therefore, I am submitting a description of this child's examination and treatment in order to share this with other pediatricians who may have already encountered or who may in the future encounter a similar clinical problem. Five days before this child's admission, the babysitter of this 12-month-old caucasian girl reported to the infant's mother that the child would not bear weight on her left foot and would not walk.
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