Avascular necrosis of the femoral head is a common disorder of childhood, but despite careful assessment of each child, a cause for the necrosis is not usually found. In adults, however, it has been shown that approximately one third of patients with idiopathic avascular necrosis of the femoral head have received drugs such as corticosteroids (Fisher & Bickel, 1971). These patients are now classified as having drug‐induced avascular necrosis. Such a group has not been previously described in children. In this paper we present the histories of 3 children in whom avascular necrosis of the femoral head probably resulted from corticosteroid therapy.

The chapter authors argue there is a distinct relationship between socially just leadership education and civic engagement, which transforms inequitable work to interrupt and reconstruct unjust systems and organizations through curricular learning and engagement. To cultivate advocacy, activism, and engaged citizenry, higher education administrators, faculty, and staff have a responsibility to engage practices for socially just leadership learning and development of college students through curricular and co‐curricular experiences.

SUMMARY The identification of patients as ‘fast acetylators’ or ‘slow acetylators’ is used in clinical practice to help recognize those at risk from toxicity and in guiding the dosage of N‐acetylated drugs. Caffeine has been proposed as a marker for drug acetylation on the basis of a ratio of urinary metabolites (5‐acetylamino‐6‐formylamino‐3‐methyl uracil and 1‐methylxanthine, AFMU:MX) determined by high‐performance liquid chromatography. The caffeine test was studied in 26 subjects by reference to the use of sulphamidine as the test substance. The distribution of urinary AFMU:MX ratios allowed assignment of subjects to ‘slow’ and ‘fast’ acetylator status (AFMU:MX <2·1 and >2·3 respectively). The results showed accordance with those from the sulphadimidine test with the exception of one subject. The possible interference of concurrent administration of sulphadimidine (as an example of a drug known to undergo metabolism by N‐acetylation) was also studied in 11 of the subjects. The interference was found to be small (apparent mean bias 11%) but of possible clinical significance.

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