How Common Are Subconjunctival Hemorrhages in Newborns and Infants?
Discussion Newborn infants should have their eye red reflexes examined looking for signs of congenital cataract, retinoblastoma and other ophthalmological problems. This can be complicated by lid edema from birth, and also antibiotic prophylaxis for gonorrhea that may have been applied to the eyes. Sometimes the physician only gets a brief look at the red reflexes. Therefore serial exams over the first days to weeks of life are important. Trauma and infection are most common in infants and young children, but causes of subconjunctival hemorrhage (SCH) include: Trauma Direct to globe and orbit Inadvertent – rubbin...
Source: PediatricEducation.org - May 20, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is the Bristol Stool Scale?
Discussion The Bristol Stool Scale (BSS) is a tool to assist patients, family members and health care providers to share common language about stool consistency. The actual language and what that language means has implications both for clinical treatment but also research results. The BSS was originally developed at the Royal Infirmary in Bristol, UK and published in 1997. The study was performed with 66 volunteers aged 15-62 years old where they looked at “normal” stools and transit time and after using senna and loperamide medications. The original Bristol Stool Form Scale description with notations in bra...
Source: PediatricEducation.org - May 13, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Treatment Options for EOE?
Discussion Eosinophilic esophagitis (EOE) is a clinicopathologic condition of the esophagus where a pediatric or adult patient has clinical symptoms of esophageal dysfunction along with 15 or more eosinophils per high powered field in histological samples. The clinical diagnosis is difficult because many presenting symptoms are consistent with gastroesophageal reflux disease (GERD). Clinical features in children include feeding intolerance or refusal, abdominal pain, emesis or reflux symptoms. Other symptoms include chest pain, diarrhea or failure to thrive. Older children and adolescents may have food impaction or dysphag...
Source: PediatricEducation.org - May 6, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Do You Diagnose Cerebral Palsy?
Discussion Cerebral palsy (CP) is defined as “…a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.” It is the most common physical disability in childhood. It occurs in 1:500 live births, with a prevalence as high as 2.1 case/ 1000 persons. Most patients are born full term. There are 4 CP types: Spastic Occurs in 85-91% May occur in one or more limbs Unilateral (hemiplegia, 38%), bilateral (diplegia, 37% with lower limbs affected more than upper ...
Source: PediatricEducation.org - April 29, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Hemoptysis?
Discussion True hemoptysis is a very uncommon or rare problem in pediatrics but can be potentially life-threatening. Massive hemoptysis has a high mortality (up to 50%) mainly from asphyxia and inability to ventilate and oxygenate the patient because of blood in the pulmonary airways. Fortunately, most hemoptysis is small in amount that resolves within 24 hours. Initial evaluation for hemoptysis can include complete blood count, coagulation studies, C-reactive protein, erythrocyte sedimentation rate, urinalysis (possible pulmonary-renal problems), radiographic imaging including chest x-ray and/or computed tomography, and...
Source: PediatricEducation.org - April 22, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is the Dose-Response for Maternal Vitamin D Supplementation in Lactating Mothers?
Discussion Vitamin D is an important vitamin for bone formation and mineral homeostasis. Hypocalcemia, hypophosphatemia, osteomalacia, rickets and tetany can all result because of Vitamin D deficiency. Deficiency is caused by inadequate dietary intakes of Vitamin D, inadequate exposure to sunlight or patients with fat malabsorption or renal disease. Even in high sun exposure areas of the world, Vitamin D deficiency can occur because of inadequate exposure due to clothing or cultural practices. Sunscreen blocks sunlight and an SPF (sun protection factor) of 8 blocks 95% of the sun, so there needs to be a careful balance bet...
Source: PediatricEducation.org - April 15, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Do You Treat Nasal Fractures?
Discussion Facial trauma is common and accounts for about 11% of all pediatric emergency room visits. Nasal fractures are fewer in younger ages but increase in incidence as children age because of increased opportunity for trauma (e.g. playing, sports, car accidents, etc.). Anatomy also plays a part as young children have more cartilaginous structures and the nose does not protrude as much as an older child or adult who also have more osseous structures. The nasal structures have 2 bigger growth phases from 2-5 years and also at puberty. Adult size is reached in 16-18 years for females and about 2 years later for males (18...
Source: PediatricEducation.org - April 8, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Is That In Her Mouth?
Discussion Exostoses are dense cortical nodular osseous structures that are benign but which can cause problems due to size or location. The tissue grows outward from the bone. Long bone locations are common. Bone spurs are a common exostosis that is specifically an osteophyte as it occurs along a joint margin. Enthesophytes are benign bony projections from the tendon or ligament insertion. Some exostoses have specific names such as Surfer’s ear (occurring in the ear canal) or Haglund’s deformity (or pump bump) that occurs on the back of the heel. People with hereditary multiple exostoses have multiple exostos...
Source: PediatricEducation.org - April 1, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Potential Problems with Baby Bottles?
Discussion The basic rules for preparing formula and using baby bottles and cups are the same for any food preparation and presentation. Wash hands with clean water. Wash with hot soapy water, rinse and dry all bottles, cups, nipples, rings or other equipment (including breast pumping equipment). Some people recommend boiling these utensils for 5 minutes as well. For glass bottles, a dishwasher with heated water and hot drying cycle can be used. Remember to include any measuring cups, measuring spoons, can opener, etc. which can also touch the formula. Wash, rinse and dry the top of the formula (or other food) container....
Source: PediatricEducation.org - March 25, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Common Is Recurrent Radial Head Subluxation?
Discussion Radial head subluxation (RHS) is most commonly occurs in children 6 months – 4 years old. It occurs because of the anatomy and child development. The radius is connected to the ulna just distal to the radial head by an annular ligament that encircles the radius “neck” (i.e. radial diaphysis) and inserts into the ulnar tuberosity. However the annular ligament is relatively small and also not as fibrous in young children compared to older children and adults. Young children often have their arm extended upward to hold hands with an adult especially when they are new walkers. If the child stumbles...
Source: PediatricEducation.org - March 18, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

PediatricEducation.org Published its 900th case!
It has been an amazing journey that started with just one weekly case and now we have come to this newest milestone. Since 2004, we have offered a breadth of cases that continues to be unstructured pediatric curriculum and educational resource. Remember that the To Learn More Section of each case is continuously updated even if the case is a little older. The Curriculum Maps and Random Pediatric Cases continue to be patron favorites for quick or more in-depth learning. We even offer translation now through GoogleTranslate – just look at the bottom left-corner and choose your preferred language. We cannot have done it wi...
Source: PediatricEducation.org - March 11, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is Twice-Exceptionality?
Discussion “Gifted individuals are those who demonstrate outstanding levels of aptitude (defined as an exceptional ability to reason and learn) or competence (documented performance or achievement in top 10% or rarer) in one or more domains.” Domains for giftedness include: Intellectual Creative Artistic Leadership Specific field – language arts, mathematics, science, etc. Giftedness is usually not screened for in young children, but may be screened for in early elementary school for potential differentiated educational programs. A review of giftedness and how it can present can be found here Individual...
Source: PediatricEducation.org - March 11, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Health Problems for Off-Spring of Mothers with Pre-eclampsia?
Discussion “Pre-eclampsia is a complex multisystem disease, diagnosed by sudden-onset hypertension (> 20 weeks of gestation) and at least one other associated complication, including proteinuria, maternal organ dysfunction or uteroplacental dysfunction…[It] is one of the most severe complications of pregnancy and a leading causes of maternal and perinatal morbidity and mortality.” Deaths per year world wide are estimated to be 500,000 babies and > 70,000 women. Women that survive have decreased life-expectancy and it is estimated that > 300 million women and children are at “…increase...
Source: PediatricEducation.org - March 4, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Winter Break
PediatricEducation.org is taking an early fall break The next case will be published on March 4th. In the meantime, please take a look at the different Archives and Curriculum Maps listed at the top of the page. We appreciate your patronage, Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - February 27, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What are Some Causes of Acute Onset of Loss of Speech Abilities?
Discussion Acute mental status changes are worrisome in the least and scary at their worst. Seizures, cerebrovascular problems and central nervous system tumor swirl in professionals’ heads as they take in the history, physical examination and start to evaluate and manage the problem. Usually respiratory distress is recognized by family members and treatment is also sought. Another cause of loss of speech is selective (or elective) mutism (SM). The child does not speak at all or minimally. When speaking it is usually within a close group of individuals or in certain circumstances such as only speaking to a parent o...
Source: PediatricEducation.org - February 19, 2024 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news