Arnold J. Rudolph – Atlas of the Newborn

Описание

Preface
I first became attracted to the idea of producing
a color atlas of neonatology many
years ago. However, the impetus to synthesize
my experience and compile this current collection
was inspired by the frequent requests
from medical students, pediatric house staff,
nurses and others to provide them with a
color atlas of the clinical material provided in
my “slide shows.” For the past few decades I
have used the medium of color slides and
radiographs as a teaching tool. In these weekly
“slide shows” the normal and abnormal, as
words never can, are illustrated.
“I cannot define an elephant but I know one
when I see one.”1
The collection of material used has been
added to constantly with the support of the
pediatric house staff who inform me to “bring
your camera” whenever they see an unusual
clinical finding or syndrome in the nurseries.
A thorough routine neonatal examination
is the inalienable right of every infant. Most
newborn babies are healthy and only a relatively
small number may require special care.
It is important to have the ability to distinguish
normal variations and minor findings
from the subtle early signs of problems. The
theme that recurs most often is that careful
clinical assessment, in the traditional sense, is
the prerequisite and the essential foundation
for understanding the disorders of the newborn.
It requires familiarity with the wide
range of normal, as well as dermatologic, cardiac,
pulmonary, gastrointestinal, genitourinary,
neurologic, and musculoskeletal disorders,
genetics and syndromes. A background
in general pediatrics and a working knowledge
of obstetrics are essential. The general
layout of the atlas is based on the above.
Diseases are assigned to each section on the
basis of the most frequent and obvious presenting
sign. It seems probable that the findings
depicted will change significantly in the
decades to come. In this way duplication has
been kept to a minimum. Additional space
has been devoted to those areas of neonatal
pathology (e.g., examination of the placenta,
multiple births and iatrogenesis) which pose
particular problems or cause clinical concern.
Obviously, because of limitations of space,
it is impossible to be comprehensive and
include every rare disorder or syndrome. I
have tried to select both typical findings and
variations in normal infants and those found
in uncommon conditions. Some relevant
conditions where individual variations need
to be demonstrated are shown in more than
one case.
As the present volume is essentially one of
my personal experience, it is not intended to
rival standard neonatology texts, but is presented
as a supplement to them. It seems
logical that references should be to standard
texts or reviews where discussion on pathogenesis,
treatment, and references to original
works may be found.
Helen Mintz Hittner, M.D., has been kind
enough to contribute the outstanding section
on neonatal ophthalmology.
I have done my best to make the necessary
acknowledgements to the various sources for
the clinical material. If I have inadvertently
omitted any of those, I apologize. My most
sincere appreciation and thanks to Donna
Hamburg, M.D., Kru Ferry, M.D., Michael
Gomez, M.D., Virginia Schneider, PA, and
Jeff Murray, M.D., who have spent
innumerable hours in organizing and culling
the material from my large collection. We
wish to thank Abraham M. Rudolph, M.D.,
for his assistance in reviewing the material.
We also wish to thank the following people
for their photo contributions to this work:
Cirilo Sotelo-Avila, Stan Connor, Avory
Fanaroff, Milton Finegold, Brian Kershan,
Tom Klima, Susan Landers, Gerardo Cabera-
Meza, Ken Moise, Don Singer, Edward
Singleton.
It is hoped that this atlas will provide
neonatologists, pediatricians, family physicians,
medical students and nurses with a
basis for recognizing a broad spectrum of normal
variations and clinical problems as well
as provide them with an overall perspective
of neonatology, a field in which there continues
to be a rapid acceleration of knowledge
and technology. One must bear in mind the
caveat that pictures cannot supplant clinical
experience in mastering the skill of visual
recall