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
Two-step Screening Strategy for Biliary Atresia in Newborns Shows Promise Two-step Screening Strategy for Biliary Atresia in Newborns Shows Promise
Newborn screening for biliary atresia using direct or conjugated bilirubin measurements has a high diagnostic yield, detecting all known infants with the rare liver disorder in a large cross-sectional study of infants born at 14 Texas hospitals.Reuters Health Information (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - March 25, 2020 Category: Consumer Health News Tags: Medscape Today News Source Type: news
Biostage Announces IND Approval from FDA for its Lead Product Candidate Cellspan(TM) Esophageal Implant
HOLLISTON, Mass., March 20, 2020 -- (Healthcare Sales & Marketing Network) -- Biostage, Inc. (OTCQB: BSTG) (Biostage or the Company), a bioengineering company developing next-generation esophageal implants, today announced that the U.S. Food and Drug Admi... Devices, Regenerative Medicine, FDA Biostage , esophageal implant, Cellspan Esophageal Implant, Esophageal Atresia (Source: HSMN NewsFeed)
Source: HSMN NewsFeed - March 20, 2020 Category: Pharmaceuticals Source Type: news
What Do You Do For Breast Milk Jaundice?
Discussion
Almost all infants in the first few days of life have some elevation of their bilirubin because of the various physiologic changes they undergo in the transition to extra-uterine life. This is a common problem managed by many different inpatient and outpatient healthcare providers. This hyperbilirubinemia is usually unconjugated and resolves in the first 1-2 weeks of life. However, when it does not resolve, health care providers have 3 general paths to follow when considering a cause: inadequate breast milk intake, an underlying organic cause or breast milk jaundice.
Inadequate breastfeeding is not uncommon and...
Source: PediatricEducation.org - February 3, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Mother, 35, risks her life to save her baby by undergoing dangerous transplant surgery
Danielle Roscoe, 35, saved her son Otis by donating part of her liver. Otis had biliary atresia and doctors in Leeds warned the baby boy would die without a transplant. (Source: the Mail online | Health)
Source: the Mail online | Health - December 23, 2019 Category: Consumer Health News Source Type: news
Yorkton family worries after city left without pediatrician
Rachel Gregoire's daughter, Alice, has esophageal atresia, which means she regularly needs to see a pediatrician. But since Yorkton lost its only pediatrician in September, the Gregoire family now needs to drive to Regina every two weeks for appointments. (Source: CBC | Health)
Source: CBC | Health - December 10, 2019 Category: Consumer Health News Tags: News/Canada/Saskatchewan Source Type: news
MMP-7 Accurately Diagnoses Biliary Atresia MMP-7 Accurately Diagnoses Biliary Atresia
Matrix metalloproteinase-7 (MMP-7) shows"good accuracy" in diagnosing biliary atresia (BA) and"holds great promise" as a marker to differentiate BA from non-BA, a single-center validation study in Shanghai reveals.Reuters Health Information (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - October 14, 2019 Category: Consumer Health News Tags: Medscape Today News Source Type: news