How Late Can You Give Routine Newborn Care?
Discussion Routine newborn screening and treatment is focused on assisting the infant’s transition to extrauterine life, screening for health problems that may or may not be easily identifiable, and preventing acute or chronic health problems. Healthy infants begin with healthy pregnancies including risk factor assessment and screening of mothers. Such routine maternal screening and treatment does or may include glucose tolerance tests, ultrasound examinations, screenings for maternal blood type (with appropriate administration of Rho(D) immunoglobulin if appropriate), Hepatitis B, Neisseria gonorrhea, Chlamydia, Cyt...
Source: PediatricEducation.org - November 20, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Late Can You Give Routine Newborn Care?
Discussion Routine newborn screening and treatment is focused on assisting the infant’s transition to extrauterine life, screening for health problems that may or may not be easily identifiable, and preventing acute or chronic health problems. Healthy infants begin with healthy pregnancies including risk factor assessment and screening of mothers. Such routine maternal screening and treatment does or may include glucose tolerance tests, ultrasound examinations, screenings for maternal blood type (with appropriate administration of Rho(D) immunoglobulin if appropriate), Hepatitis B, Neisseria gonorrhea, Chlamydia, Cyt...
Source: PediatricEducation.org - November 20, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Dysphagia?
Discussion Swallowing is a complex process with 4 phases: Preparatory – food is moistened with saliva, chewed and prepared into a bolus by teeth, tongue and hard palate. Oral – food bolus is moved into oropharynx by tongue and triggers the swallow reflex. Soft palate elevates to prevent nasopharyngeal reflux. Pharyngeal – food bolus is moved through the oropharynx and hypopharynx to the esophagus. Respiration stops briefly with vocal fold adduction and larynx elevation to prevent aspiration. Esophageal – the cricopharyngeaul muscle relaxes which allows the food bolus into the esophagus where it is ...
Source: PediatricEducation.org - October 16, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Underlying Risk Factors for Liver Abscesses?
This study specific excluded patients with ALA or candidemia. LA treatment is usually antibiotics and less invasive surgical techniques such as aspiration or percutaneous catheter drainage, but other treatment including resection is sometimes needed Overall mortality from LA has decreased from 15-40% to as low as 0.8% in the pediatric populations as noted above. Learning Point LA can occur solely because of exposure to infectious organisms but is also commonly associated with hepatobiliary pathology as well. In Northern India study, the “[m]ajority of …children had no predisposing factors for development of LA ...
Source: PediatricEducation.org - August 21, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Does Ebstein ’ s Anomaly Present?
Discussion Ebstein’s anomaly (EA) accounts for about 0.3-0.5% of all congenital heart disease and about 40% of all tricuspid valve (TV) pathologies. It was first described by Dr. William Ebstein in 1866. In EA’s simplest form, the TV is displaced inferiorly from the normal hinge points into the right ventricle (RV). This is caused by delamination of both the septal and mural leaflets and they usually form a combined leaflet which can be more adherent to the RV. These anatomical changes causes poor movement of the leaflet(s) and tricuspid regurgitation. Displacement inferiorly can cause decreased RV capacity and...
Source: PediatricEducation.org - March 13, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Meconium: It Can Cause a Sticky Mess
Discussion During fetal life from approximately 12-13 weeks gestation, meconium accumulates in the small bowel and migrates to the large bowel and rectum by ~20 weeks gestation. Meconium is a combination of bile, mucous, desquamated intestinal cells, bowel secretions, dessicated swallowed amniotic fluid and lanugo. It is sterile before birth and once produced is odorless with a blackish green (sometimes brown or yellow) color, and tarry or sticky quality. Defecation does not occur during fetal life unless the fetus is significantly stressed. Normal meconium passage after birth occurs within 24-48 hours of life (more often ...
Source: PediatricEducation.org - February 13, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Which Side Are the Organs On?
Discussion Although externally vertebrates present with bilateral symmetry, this is not necessarily true internally for humans. Humans have a normal left-right asymmetry of their internal organs. For example, the right lung has 3 lobes and is slightly larger than the left lung with 2 lobes. The normal asymmetry is called situs solitus (SS). Complete reversal of the normal abdominal and thoracic organ positions is called situs inversus totalis (SIT). Variations on the laterality between situs solitus and SIT has been referred to by different names including situs ambiguous or heterotaxy. For this case, the term situs ambigu...
Source: PediatricEducation.org - October 17, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Are These Stools Acholic?
Discussion Color can be difficult to discern and communicate. Stooling is an important part of overall health and an important harbinger of potential illness. Stooling consistency and color changes with food, environment, medication, and health conditions. For neonates and young infants, some hepatobiliary problems may not be seen at birth but in the next few days to weeks. This includes Alagille syndrome, biliary atresia and cystic fibrosis. It is not uncommon for these patients to have prolonged jaundice and therefore the diagnosis may be delayed with some presenting with increased jaundice, acholic stool and poor feedin...
Source: PediatricEducation.org - May 23, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Stridor After Tracheoesophageal Fistula Repair: Where Is the Lesion?
A male infant with a birthweight of 2,500 g (between the 3rd and 10th percentile) is born at 37 weeks ’ gestation to a 27-year-old primigravida woman with severe polyhydramnios (amniotic fluid index of 37 cm). After delivery, the neonate is vigorous, with Apgar scores of 8 and 9 at 1 and 5 minutes of age, respectively. He develops excessive frothy oral secretions, and the neonatology team is unabl e to pass a nasogastric tube. Chest radiography shows the coiling of a nasogastric tube with air in the stomach suggestive of esophageal atresia (EA) with tracheoesophageal fistula (TEF). (Source: NeoReviews recent issues)
Source: NeoReviews recent issues - January 1, 2022 Category: Pediatrics Source Type: news

Neonatal Cholestasis: Updates on Diagnostics, Therapeutics, and Prevention
Cholestatic jaundice is a common presenting feature of hepatobiliary and/or metabolic dysfunction in the newborn and young infant. Timely detection of cholestasis, followed by rapid step-wise evaluation to determine the etiology, is crucial to identify those causes that are amenable to medical or surgical intervention and to optimize outcomes for all infants. In the past 2 decades, genetic etiologies have been elucidated for many cholestatic diseases, and next-generation sequencing, whole-exome sequencing, and whole-genome sequencing now allow for relatively rapid and cost-effective diagnosis of conditions not previously i...
Source: NeoReviews recent issues - December 1, 2021 Category: Pediatrics Source Type: news

What are Some of the Complications of Short Bowel Syndrome?
Discussion Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies in neonates. Mortality rates are from 0-45% depending on infant weight and gestation with more premature and smaller infants having greater mortality. NEC usually occurs in premature infants but it also occurs in term infants. The etiology is unknown but is probably multifactorial with ischemia and/or reperfusion playing some role. There are ‘outbreaks’ of NEC but no causative organism has been identified. Regardless of the originating cause, inflammation of the intestine and release of inflammatory mediators causes variou...
Source: PediatricEducation.org - August 30, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

When Should Cutis Aplasia be Worked Up?
Discussion Aplasia cutis congenita (aka cutis aplasia, CA) is an uncommon dermal defect that is usually noted at birth or soon after birth. A variable amount of dermal tissue is absent. It is usually an isolated defect. The actual causes are unknown but genetics, developmental and destructive forces are logically the cause. Developmental forces do not allow the appropriate formation and closure of the skin (example would be a syndrome) and destructive forces (such as amniotic bands) harm the tissue so that it is disrupted. On physical examination CA may look like a small hypertrophic or atrophic scar. It can also be covere...
Source: PediatricEducation.org - February 15, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Why Biliary Atresia Demands Our Respect Why Biliary Atresia Demands Our Respect
Dr William Balistreri explains how interceding quickly can help limit the devastating effects of this rare disease in infants.Medscape Gastroenterology (Source: Medscape Gastroenterology Headlines)
Source: Medscape Gastroenterology Headlines - August 19, 2020 Category: Gastroenterology Tags: Gastroenterology Commentary Source Type: news

What Are the Main Acyanotic Congenital Heart Diseases?
Discussion Congenital heart diseases (CHD) are malformations of the heart and great vessels. It occurs in about 5-8/1000 live births. Cyanotic congenital heart disease is often noted perinatally because of cyanosis, respiratory distress and/or poor feeding or other distress type problems. A review can be found here. Acyanotic congenital heart disease (ACHD) can present at birth but often is seen in older children or adults unless the lesions are severe, especially obstructive lesions. Severe lesions may also cause cyanosis and distress type problems in patients also. Shunting lesions cause problems by diverting blood flo...
Source: PediatricEducation.org - August 17, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news