Summer Break
PediatricEducation.org is taking a summer break. The next case will be published on August 17, 2020. In the meantime, please take a look at Random Cases or 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 - August 3, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Common Fatty Acid Oxidation Metabolic Disorders?
Discussion All cells and particularly their mitochondria need an energy source. Glucose is one of the most common ones, but also fatty acids, lactate, pyruvate, ketones, and amino acids. Fatty acids are formed with a carboxylic acid with a long aliphatic carbon chain usually with even numbers of carbon atoms (usually 4-28 most commonly). Most are unbranched and in foods are usually found in the form of esters. Fatty acids are important energy sources for the heart (50-70%) but also skeletal muscle where resting muscle uses both glucose and fatty acids. During fasting or increased stress fatty acids become a major source o...
Source: PediatricEducation.org - July 27, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Some Pediatric Oncological Emergencies?
Discussion Pediatric cancers in the US number about 12,000 per year. After injury, it is the second leading cause of death in children and adolescents. Cancer presentations vary widely, but often begin with non-specific symptoms that continue or progress depending on the location and tumor type. Patients can present with oncological emergencies especially if there are mechanical obstruction such as superior vena cava syndrome or cerebral herniation. More commonly are infections due to immunosuppression. Cancer treatment also causes its own myriad of problems that clinicians need to be aware of to diagnosis and treat, but a...
Source: PediatricEducation.org - July 20, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Early Pregnancy Vaginal Bleeding?
Discussion Pregnancy complications in early pregnancy range from mild to severe. They can include nausea and emesis which often is treated symptomatically, but can cause hyperemesis gravidarum and need hospitalization for intravenous fluids. Mild cramping and slight spotting are not uncommon. Some type of pregnancy bleeding is common with 20-40% of women experiencing it. Women who have early vaginal bleeding have a higher risk of later pregnancy complications. Pregnancy in adolescents is about 10% of all pregnancies. Adolescent pregnancy can be associated with various problems including higher rates of threatened aborti...
Source: PediatricEducation.org - July 13, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

When Can You Use A Fingerprint to Identify Someone?
Discussion Biometrics uses “biological characteristics or behavioral features to recognize an individual.” Using biometric data requires acquisition of data of sufficient quantity and quality for recognition and comparison, and the biometric data needs to remain stable over time (i.e. – the person should be able to be recognized in the future using the data. Data acquisition and storage cost and size are also important variables. Privacy and security are also paramount considerations. Biometrics use in pediatric patients has several applications including: Newborn tracking -using biometrics for iden...
Source: PediatricEducation.org - July 6, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Examples of Infantile Primitive Reflexes?
Discussion As part of the normal developmental process of central nervous system maturation, primitive reflexes (i.e. infantile automatisms) occur which are automatic movement patterns which can begin during fetal development and continue after birth. Some appear important for human survival such as rooting and sucking to obtain nutrition. Others may be phylogenetic remnants. Primitive reflexes are present and disappear at predictable times and therefore can assist in evaluation of infant development. There is a range of normal and some can persist to older ages in some individuals. Primitive reflexes that occur before or ...
Source: PediatricEducation.org - June 29, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Bradycardia?
Discussion Bradycardia is a heart rate below what the lowest value that is normal for age. Infants and children have higher heart rates that slowly decrease with age to adult levels. It is usually noted as an incidental finding because of increased vagal tone. Reasons for cardiology referral include associated heart murmur, syncope especially if associated with exercise or unusual triggers, other signs such as chest pain or palpitations, family history of sudden cardiac death, congenital heart disease or familial heart disease, bradycardic medication use, or unusual symptoms associated with the concern. Severe bradycardia ...
Source: PediatricEducation.org - June 22, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Pyogenic Granulomas?
Discussion Pyogenic granuloma (PG) is a benign, vascular lesion of the skin. PGs are red, small, often pedunculated nodules that can rapidly increase in size (up to 1-2 cm). They also can often ulcerate and bleed. They frequently occur on the head and neck, with back and chest being the next most common locations but can occur in other locations. They usually are solitary and do not regress. They are seen in children (mean age 6.7 years), young adults and pregnant women (5%). Treatment is electrocautery or excision. Learning Point PG’s cause is not fully understood. A gene has recently been identified with PG sugge...
Source: PediatricEducation.org - June 15, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Free Peritoneal Fluid?
Discussion Peritoneal fluid is normal. It decreases the friction of the peritoneum covering abdominal and pelvic organs and helps to protect them and allow their movement. A normal amount of peritoneal fluid is expected on radiological evaluation. Increased peritoneal fluid is a continuum and is concerning as a wide variety of pathological causes are associated with it such as abdominal trauma and appendicitis. At the far end of the scale is ascites that is the accumulation of free fluid more than 25 ml. It is usually associated with abdominal distension but fluid must accumulate before distension can occur and therefore i...
Source: PediatricEducation.org - June 8, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is Dry Needling?
Discussion Myofascial pain is pain from muscle or fascia, and usually associated with myofascial trigger points which are “…a highly localized, hyperirritable spot in a palpable, taut band of skeletal muscle fibers.” Trigger points are common reasons people, especially adults, seek relief in primary care or pain clinic settings. Athletes may also complain of pain caused by them. They are treated in a variety of ways, none of which used as a single method is successful for all individuals. Muscle “…stretching, massage, ischemic compression, laser therapy, transcutaneous electrical nerve stimu...
Source: PediatricEducation.org - June 1, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Long Does Neonatal Galactorrhea Last?
Discussion Galactorrhea is a milky discharge from the breast in a non-lactating female. Neonatal galactorrhea is sometimes called “Witch’s Milk” based on ideas from the 17th century or earlier that witches would steal the milk for use in their magic. Infant breasts were often compressed to express the fluid and prevent its collection. During the 19th century, reports of breast inflammation and even abscess were reported because of this practice and it was strongly discouraged, and continues to not be recommended today. Enlargement of neonatal breasts and galactorrhea, both for males and females, is fel...
Source: PediatricEducation.org - May 25, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Potential Complications of Tattooing?
Discussion “Tattooing of skin via deposition of pigment particles and ink ingredients in the dermis changes normal skin into abnormal skin. Fortunately, this often causes no harm and no disease, although with important exceptions.” Tattoos can be inadvertent from road dirt, gunpowder, pencil graphite etc., but most are desired. Tattoos are common in many cultures and over time..They have been increasing in popularity in the United States over the past few years particularly with a younger, wider and more diverse population. Newsweek reported an 18-country study in 2018 which showed 46% of Americans have a tat...
Source: PediatricEducation.org - May 18, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Much Breast Milk Does a Lactating Woman Make?
Discussion Each person needs to eat the right about of healthy foods to maintain a healthy body. This varies based on gender, age, activity, healthy problems, or health status. Healthy women who are moderately active and not pregnant or lactating need about 1800-2000 calories/day. Pregnant women are advised to keep the calories the same in the first trimester (about 1800 calories/day), increase ~200-300 (about 2200 calories/day)in the second trimester, and then increase ~300-400 in third trimester (about 2400 calories/day). The increase in calories should be met by a normally balanced and varied diet. When pregnant or br...
Source: PediatricEducation.org - May 11, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Complications of Inhalant Abuse?
Discussion Hydrocarbons (HC) are organic compounds that are abused because they produce a euphoric effect, usually quickly, are low cost and easily obtained. They are commonly abused by adolescents and use in the US is either stable or increasing. Volatile HC rapidly distribute throughout the body which produces euphoria in seconds to minutes. There are 3 ways that HC are inhaled: Sniffing – directly inhaling the HC from the container. This has the lowest HC concentration. Huffing – a cloth is saturated with the HC and then the cloth is held to the nose and mouth and inhaled. This has a higher concentration ...
Source: PediatricEducation.org - May 4, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Fragile X in the Family
Discussion Fragile X syndrome (FXS) was first clinically described in 1943 by Martin-Bell and in 1969 Lubs found a fragility at the terminal end of the X chromosome. In 1991, three different research groups independently cloned the mutation for the FMR1 gene (Fragile X mental retardation type 1) which has a CGG triplet expansion. The FMR1 gene codes for the FMR protein which is a major regulator of synaptic plasticity and is expressed in the brain and spermatogonia mainly but many other tissues during fetal and early neonatal development. The number of triplets and methylation correlates with clinical expression (increased...
Source: PediatricEducation.org - April 27, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Are Taste Preferences Genetic?
Discussion Taste or gustation is the sensation of taste and is a primary human sense. There are 5 basic tastes currently accepted including sweet, sour, bitter, salty and umami or savory. There is also some data for distinct tastes of fats (called oleogustus) or complex carbohydrates. Taste buds in the oral cavity are the primary chemoreceptors of whether or not to allow a substance into our bodies. Taste receptors are also found in the gastrointestinal tract and are involved in gut sensing. Flavor and taste are not the same although in general everyday language people use them interchangeably. Flavor is “… t...
Source: PediatricEducation.org - April 20, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Good Is Infrared Thermography for Mass Screening for Fever?
Discussion The purpose of measuring temperature is to monitor the health of the individual and evaluate for a potentially abnormal physiological state such an ambient hyper/hypothermia or infectious disease. Rectal and esophageal temperature are considered the two most reliable measures for the gold standard of core body temperature. Oral, axillary and inguinal temperatures are common alternative measurement sites but do underestimate core body temperature. These sites often use digital/electronic temperature measurements and contact with the patient’s skin which is not helpful for high volume screening locations. An...
Source: PediatricEducation.org - April 13, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Common are Congenital Rib Abnormalities?
Discussion The embryonic mesoderm forms the skeletal system. The mesoderm is further divided into the dorsal, sclerotome and ventral dermatome. The sclerotome forms the ribs which are under the influence of various genes and growth factors. Congenital rib abnormalities occur in number ( the normal 12 ribs) or in formation/structural. Malformations can include hypoplastic, bridging, forked, fused and hypoplastic ribs. Even ribs with holes occur because of the segmentation issues. Illustrated examples can be found here. The rib’s cartilage, bone or both can be affected. Location along the rib is also variable. Abnormal...
Source: PediatricEducation.org - April 6, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Types of Memory Impairments are There in Children?
Discussion Memory is an important part of what distinguishes higher order species from others. Memory also is part of one’s self-identity. Difficulties in short-term memory can make common, everyday tasks difficult for the person experiencing the problem particularly if it recently occurred and the person’s long-term memory is intact. Difficulties with long-term memory can also have problems when language, events or even one’s own identity are affected. For some people the memory loss is temporary but for others, memory impairments are permanent and must be accepted and accommodated as part of the overall...
Source: PediatricEducation.org - March 30, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Tachycardia?
Discussion Tachycardia is a rapid heart rate that is above normal for age and level of exertion. Tachycardia is common, particularly sinus tachycardia due to normally encountered circumstances such as pain, fever or exercise. It is usually a normal physiologic process but sustained tachycardia often indicates a potentially abnormal underlying cause. Sinus tachycardia has a rapid heart rate with normal P waves and P-R intervals and variations from moment to moment and respiration. Generally it is not over 200 beats/minute. Vagal stimulation can slow the heart rate; this is a gradual slowing, not an abrupt slowing seen in ...
Source: PediatricEducation.org - March 23, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Short Break
PediatricEducation.org is taking a short break. The next case will be published on March 23. 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. Holiday Break (Source: PediatricEducation.org)
Source: PediatricEducation.org - March 16, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Some Risk Factors for Cerebral Palsy?
Discussion The term, cerebral palsy, or CP has gone through many iterations with the first description in 1861 by W.J. Little who described it as “The condition of spastic rigidity of the limbs of newborn children.” The most recent definition is from Rosenbaun et al. in 2007 which states it is “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. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cog...
Source: PediatricEducation.org - March 9, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Neutropenia?
Discussion Neuropenia is defined as a neutrophil count
Source: PediatricEducation.org - March 2, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Safety Guidance Should Farm Families Be Aware Of?
Discussion “The agriculture industry is consistently ranked as one of the most hazardous industries in the United States with some of the highest rates of work related injuries and deaths. Agriculture is a unique profession in that children who live on farms are exposed to, and in participate in, the family business of farming. Moreover, children who work on their family farm fall outside the regulation of governmental safety and labor practices….There is often little separation between work areas and play or living areas, thus children living on or visiting a farm may be in close proximity to safety hazards. ...
Source: PediatricEducation.org - February 24, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Different Types of Myasthenia Gravis?
Discussion Myasthenia gravis (MG) is a problem of the neuromuscular junction which causes muscle weakness. It can occur in all ages and have a range of symptoms from mild localized disease to mortality-threatening respiratory failure. MG occurs in 1.7-30 cases/million, with a prevalence of 77.7 cases/million. Pediatric patients comprise 10-15% of all patients with MG. In various Asian populations, the juvenile MG can be up to 50% of all of the MG cases. Fluctuations in muscle weakness is a hallmark of the disease. As a reminder, “[i]n normal synaptic transmission in the neuromuscular junction, the axon is depolarize...
Source: PediatricEducation.org - February 17, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

When Does Executive Function Happen?
Discussion Executive function (EF) is the “…cognitive processes that facilitate goal-directed action and problem solving, such as working memory, cognitive flexibility, inhibitory control, and self-monitoring. EF skills are important for the conscious, effortful control of thoughts and behaviors.” EF allow us to inhibit ingrained behaviors that could get us into trouble, e.g. shouting out in a classroom, driving the wrong-way down a one-way street. EF also allow us to pay attention to what is meaningful for the time and situation e.g. academic testing, paying attention to traffic and not the radio while...
Source: PediatricEducation.org - February 10, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized 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

Should We Worry About Bicuspid Aortic Valve?
Discussion The aortic valve usually has 3 leaflets. In bicuspid aortic valve (BAV) there are 2 asymmetric leaflets with a fish-mouthed orifice between them which may not open fully. It occurs in about 0.5-2% of the population making it one of the most common congenital heart anomalies and the most common one in adults. Transmission is autosomal dominant yet males are more likely to have BAV, indicating potential reduced penetrance in females. “BAVs are different, however, in that the tissue pathology is not limited to the valves’ leaflets but extends from the left ventricular outflow tract to the ascending thor...
Source: PediatricEducation.org - January 27, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Who Self-Harms?
Discussion IF YOU ARE IN A CRISIS SITUATION AND NEED HELP, call 1(800) 273-TALK(8255) there IS someone there who can help you, En Espanol 1-888-628-9454, or Text “HOME” to 741-741. Other resources are available at http://www.suicidepreventionlifeline.org Non-suicidal self-injury (NSSI) is defined as the intentional, self-inflicted damage to the surface of the body without suicidal intention, which is not socially sanctioned[,]” such as piercing or tattooing. Examples of NSSI include self-cutting (70-97%), hitting (21-44%), burning (15-35%), scratching, banging, scraping or carving. The prevalence is in...
Source: PediatricEducation.org - January 20, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Is the Classic Clinical Presentation of Pericarditis?
Discussion The pericardium is a bi-layered membrane that envelops the heart and provides a barrier to prevent disease and also decreases friction as the heart moves. Pericarditis is the inflammation of pericardium. The incidence is underreported as asymptomatic or mild disease may go unrecognized. From hospitalized patient data, 0.2-5% of patients with various cardiac disease had pericarditis. An incidence rate for hospitalizations of 3.32 per 100,000 person years has been cited. Percarditis occurs more often in adolescent males. Treatment of the underlying cause or suspected cause is important, along with close monitorin...
Source: PediatricEducation.org - January 13, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What are Indications for Wisdom Teeth Removal?
Discussion Third molars (M3) are often referred to as wisdom teeth. They begin calcification at 7-9 years and usually erupt between 17-26 years. They usually erupt behind the second molar into what may be limited space. M3 can also fail to erupt. Impacted M3 occur because of abnormal position, obstruction, or lack of space. There are 4 potential groups to consider for M3 management: Group 1 – symptomatic with clinical disease Epidemiology: common Clinical presentations: edema, pain, trismus Disease: caries, pericoronitis and infection are common Treatment: treatment of disease is important but extraction is recom...
Source: PediatricEducation.org - January 6, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Holiday Break
PediatricEducation.org is taking an end of the year break. short break. The next case will be published on January 6,2020. If you are inclined you can review “Why Is it Called Christmas Disease?” or take a look at the new Curriculum Map for pediatric residents new Curriculum Map for pediatric residents based on the American Board of Pediatrics content outline. We appreciate your patronage, Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - December 23, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Some Potential Adverse Effects of Blood Donation?
Discussion Just under 40% of people are eligible to be a blood donor. Up to 6.5% of a population are actual donors. “Blood donors are healthy volunteers who give either whole blood or blood components by apheresis including platelets, plasma, red blood cells, peripheral blood stem cells and leucocytes or a combination of blood components. They represent a large, healthy population exposing themselves voluntarily for altruistic, sometimes financial motives to potential complications and risks.” Blood banking systems world-wide are responsible for caring for individual donors health as well as maintaining a robus...
Source: PediatricEducation.org - December 16, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Does Gaucher Disease Present?
Discussion Gaucher disease (GD) was first described by Philippe Gaucher in 1882. It was the first lysosomal storage disease (LSD) described and is the comparison prototype for many variations and their treatment. There are about 50 LSD and more well-known ones include Fabry, Niemann-Pick and Pompe diseases. LSDs currently have more than 300 different enzymes or membrane proteins affected which cause central nervous system and visceral disease. Overall the frequency of LSDs in aggregate is 1:3000 – 7000 live births. GD has an estimated prevalence of 1:57,000 – 111,000. It is higher within the Ashkenazi Jewish po...
Source: PediatricEducation.org - December 9, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Respiratory Failure?
Discussion The respiratory system is a complex system. The upper airways must remain patient. The lower airways must interface with the vascular system. The musculoskeletal system must provide mechanical function and the central nervous system must provide overall control. Respiratory failure occurs when the overall system cannot support the body’s necessarily ventilation, oxygenation or both. Children are at higher risk of respiratory failure. They have few intrinsic lung parenchyma problems, but have very small airways that increase the airflow resistance by themselves but then have to contend with problems such as...
Source: PediatricEducation.org - December 2, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Is Hidradenitis Suppurativa Treated?
Discussion Hidradenitis suppurativa (HS) is a recurrent, chronic inflammatory disease of the hair follicles particularly in the apocrine gland-bearing areas of the axilla, inguinal, perianal, mammary and inframammary areas. Onset is usually after puberty, in the early 20s. It is more common in females than males. Prevalence is estimated to be 0.05- 4.1%. It can be associated with premature adrenarche, metabolic syndrome and obesity. The lesions are often pruritic, painful, and with malodorous purulent drainage. It often begins with comedomes and tender nodules, and can easily progress to painful abscesses with purulent f...
Source: PediatricEducation.org - November 25, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is the Lifespan for a Child with Holoprosencephaly?
Discussion Holoprosencephaly (HPE) is a clefting problem of the brain. “[HPE] the result of incomplete or absent midline division of the embryonic forebrain into distinct cerebral hemispheres (prosencephalon) between the 18th and 28th day after conception.” There are four distinct subtypes: Alobar – both hemispheres are completely fused and are not separated into the left and right hemispheres. There is agenesis of the corpus callosum, arrhinencephaly and a single ventricle with fused thalami. Facial features are almost always affected. Semilobar – the cerebral hemispheres are fused anteriorly bu...
Source: PediatricEducation.org - November 18, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is the Long-term Outcome of ACL Repair?
Discussion The anterior cruciate ligament (ACL) “is an intra-articular but extrasynovial collagenous structure with limited healing capacity that originates in the posteromedial aspect of the lateral femoral condyle and crosses into anteromedially to insert anterior into the intercondylar eminence of tibial articular surface.” It plays an important part as a mechanoreceptor particularly as a proprioceptor. Its main role is to prevent excessive anterior tibial translation, limits varus/valgus stress when the knee is in full extension and some rotary movements of the knee. There are ~120,000 surgeries per year m...
Source: PediatricEducation.org - November 11, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Does Non-Verbal Mean?
Discussion Children can be non-verbal for many reasons with most just not wanting to talk in a given situation for a short period of time (e.g. angry with a person, scared to give a speech at school, etc.). Children may have the ability to communicate verbally but for some reason it is physically impaired for a period of time. Selective mutism (SM) “… is characterized by an individual’s consistent failure to speak in social situations in which there is an expectation to speak (e.g., at school), despite speaking in other situations.” The lack of speech cannot be due to discomfort speaking in a give...
Source: PediatricEducation.org - November 4, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Indications for Dermatological Light Treatment?
Discussion Spider telangiectasia or spider angiomas have a central red lesion with radiating dilatation of the distal, end vasculature that resemble arachnid appendages. They are common lesions (up to 38% in one study of children, and 60% in pregnant women), often solitary or
Source: PediatricEducation.org - October 28, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

“ Bulking Up ” For Sports?
Discussion Athletes, whether recreational or competitive, who participate in weight sensitive sports commonly gain or lose weight to achieve a particular body type or to improve performance. Athletes in duration or aesthetic sports (such as distance running, diving, dance, etc.) attempting to lose weight to be able to move the body against gravity better. Sports that emphasize strength and power including combat sports (such as football, wrestling, mixed martial arts, body building, etc.) often have athletes attempting to gain weight and lean muscle mass to improve performance. This is felt to increase the strength-to-weig...
Source: PediatricEducation.org - October 21, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Common is Lyme Disease Globally and in Urban Settings?
Discussion Lyme disease (LD) is caused by several genospecies of Borrelia burgdorferi senu lato that are transmitted by ticks of the Ixodes ricinus complex. In the U.S. and Europe it is the most common vector-borne disease. It is named for Lyme, Connecticut in the 1970s when it was “discovered,” but there are reports of LD-type disease in Europe since 1883. There are 18 distinct genospecies with B. afzelii, B. garinii and B. burgdorferi sensu stricto being the 3 most common ones causing human infection. There are many species of Ixodes ticks but only 4 commonly bite humans. Ixodes ricinus mainly in Europe, I, p...
Source: PediatricEducation.org - October 14, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Can Radiolucent Foreign Bodies Be Identified?
Discussion Foreign bodies are common problems for young children particularly ages 2-4 years who will mouth many objects and aspirate or swallow them. Children will also place foreign objects in other body orifices such as ears or noses. It is also not uncommon that young girls will inadvertently have toilet paper caught in the vaginal area during hygiene. Many of these foreign bodies may work their way out naturally not causing any problems, or may come to attention later because of chronic problems such as a foul-smell or discharge. Older children may tell adults that they have placed a foreign body in an orifice and thu...
Source: PediatricEducation.org - October 7, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Affects the Nutritional Quality of Plant-Based Milk Substitutes?
Discussion People today may be eating more plant-based products because of: Allergen avoidance – lactose or cow’s milk allergy, 14% of people with cow’s milk allergy will also have soy allergy. Cultural importance Contamination avoidance e.g. growth hormone or antibiotic residues in cow’s milk production Specific diseases, e.g. cholesterol/lipid issues Environmental impact Ethical or religious considerations Improved nutrition With population growth “[t]he demand for food is expected to grow by 70% until 2050….While the expected protein consumption is believed to grow by 80%.” ...
Source: PediatricEducation.org - September 30, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Pulmonary Embolism Risk Factors?
Discussion Pulmonary embolism (PE) is potentially life-threatening but fortunately rare event especially in the pediatric population. It was first described in children in 1861. PE is likely underreported because of minimal or non-specific clinical symptoms. The incidence is estimated at 0.05-4.2% with the 4.2% based on autopsy reports. It is probably also increasing as more central venous catheters (CVC) are used, and more children are surviving previously poor prognostic diseases. There is a bimodal distribution with cases
Source: PediatricEducation.org - September 23, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Is This a Fasciculation?
Discussion Benign fasciculations are very common and occur in up to 70% of the general population. They occur at different points in people’s lives. They can be brought out by stress, poor sleep hygiene and caffeine. Caffeine has numerous uses especially for regulating sleep and attention. However too much can cause restlessness, jitteriness and sleep deprivation too. The recommended amount of caffeine for a teenager is
Source: PediatricEducation.org - September 16, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Good are Masks for Preventing Infection?
Discussion With continued exposure to respiratory pathogens and the emergence of novel respiratory pathogens, personal protective equipment (PPE) and procedures are important for decreasing occupational exposure to respiratory pathogens. PPE and procedures are particularly important when anti-infective treatments or vaccination are unavailable or have limited effectiveness. Medical masks are “[a]lso known as a surgical or procedure mask. As personal protective equipment, a facial mask is intended to protect caregivers and health-care workers against droplet-transmitted pathogens, or to serve as part of facial protect...
Source: PediatricEducation.org - September 9, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is the Dosing of CBD Oil?
Discussion Cannabis sativa makes small fruits which are usually named “seeds” although they are not technically a seed. Hemp oil is derived from the hemp seeds by cold-pressing or other means of macerating or squashing the seeds. Cold pressed oil is high in polyunsaturated fatty acids including various omega-3 and linolenic acids and antioxidants. It is used by some people for its nutritional value and “[a]ccording to an old legend, Buddha (Prince Siddharta Gautama) founder of Buddism, was able to survive eating only one hemp seed each day for six years.” The seeds themselves do not contain any psyc...
Source: PediatricEducation.org - September 2, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Is Physical Activity the Same for Traditionally Schooled and Homeschooled Children?
Discussion Homeschooled children are a diverse group of students who are not participating in the traditional model of a children going off to a separate school location 5 days a week for instruction by educational professionals. If homeschooled, children may not be subject to all or some of the regulations for traditionally-schooled children regarding curricular measures, record keeping, reporting, and testing. Children in homeschooled environments also may not have access to other services that are provided through traditional schools such as special education services. Some research data shows positive academic and soci...
Source: PediatricEducation.org - August 26, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What Does the General Pediatrician Do When There Are Concerns for a Rare Disease?
Discussion Bardet-Biedl syndrome (BBS) is a rare disorder. It is usually considered an autosomal recessive disorder but there is significant intra-familial variability. There are multiple genes (~20 currently) involved and it is believed that the phenotypic variability is due to “…differences in the total mutational load across different BBS associated genes….” It is a ciliopathy where mutation changes in proteins in the cilias causes problems in the cilia’s functioning particularly signaling. Cilia are important in signaling to maintain tissue and cellular homeostasis. Obviously screening o...
Source: PediatricEducation.org - August 19, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news