How Common are Aortic Aneurysms?
Discussion Aortic root dilatation or thoracic aortic aneurysm occurs in 6:100,000 individuals> 50 years of age. It is due to aging, hypertension, hypercholesterolemia, and smoking. Tertiary syphilis was a cause in the preantibiotic era. Pediatric aneurysms are very uncommon but the exact prevalence is different due to the various causes. Aneurysms are due to genetic disorders, congenital anomalies or post-surgical repair. In pediatric patients with sudden cardiac deaths, 5.4% are due to ruptured thoracic aortic aneurysms. Learning Point Some causes of pediatric aneurysms include: Familial thoracic aneurysm and dissecti...
Source: PediatricEducation.org - February 22, 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

What is a Lipschultz Ulcer?
Discussion Acute genital ulcers (AGU) are much less common in sexually-naive women than sexually experienced or active women. The differential diagnosis of AGU is large. For sexually active women Herpes simplex virus is the most common cause. Sexually transmitted infections are also included in this differential. In addition to the pain, AGUs can cause distress for the patient and family as possible sexual abuse must be considered. The differential diagnosis of AGU in non-sexually active women includes: Aphthosis Lipschutz ulcer Idiopathic Autoimmune or inflammatory diseases Behcet disease Bullous pemphigoid Inflammato...
Source: PediatricEducation.org - February 8, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Potential Complications of Hearing Aids?
Discussion Hearing loss can range from profound deafness to fairly minor loss. The causes vary based on age, type of loss (sensorineuronal or conductive, about half of hearing loss in children has a genetic cause), degree and audiometric configuration. Sensorineuronal hearing loss involves the cochlea and neural connections to the brain and auditory cortex. Conductive hearing loss involves structures from the external ear to the oval window. Deafness is defined as a hearing loss> 90 dB. Hearing loss can affect the living and learning of children more than many people realize. “A child with a mild hearing loss can ...
Source: PediatricEducation.org - February 1, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Lethargy?
Discussion Lethargy is a common word used to describe a person who is drowsy, sluggish, listless and apathetic. Concentration may be difficult and they may have problems doing simple tasks. Many people actual mean fatigue or lassitude or being more tired when they use the word. In medical terms, lethargy is usually used to describe patients who have some type of excessive tiredness and usually have mental status changes with decreased alertness or arousal. Patients and health care providers both usually qualify the term and give more description to better communicate what is implied when using the term. This is true of man...
Source: PediatricEducation.org - January 25, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Potential Problems of Congenital Lung Malformations?
Discussion Congenital lung malformations (CLM) are commonly identified with prenatal ultrasound and occur in ~1:2400 live births. The natural history shows that lesions may remain the same, enlarge or appear to disappear. There is a wide-range of clinical manifestations. Patients may be asymptomatic or symptomatic at birth and often develop symptoms later. The overall natural history is difficult to ascertain as there are fewer studies done in older children and adults. Those that are done often lack a good denominator by which to judge the incidence or prevalence. Resection is carried out usually if a patient is symptomat...
Source: PediatricEducation.org - January 18, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Long Do You Monitor Neonates for Neonatal Abstinence Syndrome (NAS)?
Discussion Neonatal abstinence syndrome (NAS) occurs in the first few days of life and is a complex withdrawal syndrome. The newborn is abruptly cut-off from their exposure to licit or illicit drugs that the mother is chronically consuming and which were being transmitted through the placenta to the fetus. “NAS is a highly variable and severe condition; it may be associated with central and autonomic nervous system dysfunction … and gastrointestinal disorders.” It can cause significant morbidity but is rarely fatal. Fetal exposure has been increasing in the United States. In 2011-12, almost 5.9% of pregn...
Source: PediatricEducation.org - January 11, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Good is Photoscreening For Young Children ’ s Vision Problems?
This study showed that not only was smartphone photoscreening feasible, but was quite good at screening for potential vision problems. Smartphone photoscreening has the advantages of being more ubiquitously available and thus children in almost any location can be screened. A study of photoscreening using a handheld digital photoscreener in primary care offices validated the technology showing an overall referral rate of 10% to an ophthalmologist with suspected astigmatism, anisometropia and strabismus being the most common reasons. The overall positive predictive rate was 0.60. “…[O]ver 60% of children referr...
Source: PediatricEducation.org - January 4, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Holiday Break
PediatricEducation.org is taking an end of the year holiday break. The next case will be published on January 4, 2021. 2020 has been a challenging year for everyone. We wish you and your family and friends a safe holiday season and 2021. In the meantime, please take a look at the different Archives or explore one of the Curriculum Maps listed at the top of the page. Try your hand at the Random Cases too. We continue appreciate your patronage, Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - December 21, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Potential Complications of Breast Surgery?
Discussion Common reasons for seeing a breast surgeon would include management of benign or malignant masses with or without breast reconstruction, breast augmentation, and other reasons can be infection or trauma that need surgical treatment. The breast is formed starting around the 6th week of gestation by breast buds along the mammary line. Breasts then develop from the downgrowth of epithelia into the mesenchymal tissue, which continues to grow. Around 8-9 months a pit forms as entry into the lactiferous ducts. “Nipple inversion is caused either by failure of the lactiferous ducts to develop and grow during matur...
Source: PediatricEducation.org - December 14, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Areas of the Physical Examination are Important in the Pre-participation Physical Examination?
Discussion Participation in organized or non-organized, recreational to elite sports activities can provide excellent recreational and leisure time activities and improve physical and mental health for participants. The Aspen Institute in 2018 reported that more kids are being physically active, more are trying different sports, and multisports play is increasing rather than strict specialization. Unfortunately they note that there is an economic inequality with children from lower-socioeconomic circumstances playing less organized sports. About 70% of children and youth participate in an individual or team sport, but unfo...
Source: PediatricEducation.org - December 7, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Common Are Bone Spurs in Young Athletes?
Discussion The terminology of abnormal calcification of soft tissues and uses of the terms is often muddied. Especially as the causes may be similar and multiple adjacent tissues may be involved. An exostosis is an abnormal proliferation of bone from the joint. They can appear in various forms and in many locations. An osteophyte is also known as a bone spur and is type of exostosis. Osteophytes are thought to be periosteal or synovial mesenchymal stems cells that become calcified. They usually have a more narrow or pointed projection from the joint. Osteophytes are a very common feature of osteoarthritis. Enthesophytes a...
Source: PediatricEducation.org - November 30, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What are Potential Problems Associated with Helicobacter pylori?
Discussion Helicobacter pylori (H. pylori) is a microaerophilis, spiral bacterium that is a prevalent human pathogen. How this infection affects individuals is different in adults and children. Overall seroprevalence rate in children world-wide was estimated to be ~33%, but this seroprevalence rate is decreasing in the developed world for both adults and children. It is acquired in childhood and can persist through colonization throughout life if untreated. Fortunately, it often is asymptomatic and generally does not cause serious disease in children. Some serotyping data shows that within families children acquire it more...
Source: PediatricEducation.org - November 23, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Distinguishes Childhood Masturbation from Other Potential Diagnostic Entities?
Discussion “Childhood masturbation (CM) is defined as self-stimulation of the genitalia in a prepubescent child.” CM is normal sexual behavior and can be noted at all ages including infancy. It becomes very common after puberty. It is one of the most common sexual behaviors. CM can resemble the same adult masturbatory activity including flushing, sweating, muscular contracting and breath holding or tachypnea. However in younger children these changes are not recognized, are interpreted differently or infants and young children may also have different activities. “…(1)stereotyped posturing of the lo...
Source: PediatricEducation.org - November 16, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Oral Equivalents of Milia of the Face?
Discussion Milia are small, usually
Source: PediatricEducation.org - November 9, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Common Presentations for Factitious Disorder?
Discussion Factitious disorder (FD) is when patients fabricate illness in themselves or another person without obvious gain. FD has had other terminology and in the past has been called Munchausen Syndrome (if FD in themselves) or Munchausen Syndrome by proxy or FD by proxy (if FD being perpetuated in another person). The current DSM-V terminology is FD imposed on self or FD imposed on another. Malingering (sometimes referred to as simulation) is similar but those that fabricate illness or medical need have an obvious external reward such as gaining access to public social service benefits, free hospital room and board, or...
Source: PediatricEducation.org - November 2, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Joint Pain?
DiscussionMusculoskeletal problems are common problems in pediatric practice with up to 15% of acute care visits being for this problem. Joint pain is a common concern for families but the differential diagnosis is extensive and needs thoughtful consideration. History is a key to discerning the potential diagnosis but also in guiding the physical examination and laboratory examination. Family history especially for systemic diseases should be considered. On physical examination all joints should be examined include sacroiliac and temporomandibular joints. Is this arthritis or arthralgia? Distinction between inflammatory...
Source: PediatricEducation.org - October 26, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How are Personality Disorders Clustered?
Discussion Personality traits (PT) represent patterns of thinking, perceiving, reacting, and relating that are relatively stable over time. There are 5 major PT: Extraversion (e.g. tendency to be sociable) Neuroticism (e.g. susceptibility to negative thoughts and distress) Conscientiousness (e.g. self-regulation and being able to look at long term goals) Agreeableness (e.g. self-regulations and relationship maintenance) Openness to experience (e.g. imaginative, creative, curiosity). Personality disorders (PD) occur when these personality traits become so conspicuous, rigid and maladaptive that they cause impairment in ...
Source: PediatricEducation.org - October 19, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What are Potential Complications of Ichthyosis?
Discussion Ichthyosis is a large group of dermatological disorders which are caused by abnormal epidermal differentiation. The term ichthys means fish and refers to the scale-like dermatological pattern seen in these disorders. Acquired ichthyosis is rare but more common in adults than children and has a rough, dry skin with prominent scaling, distributed symmetrically on the trunk and limbs (especially extensor surfaces), and is associated with autoimmune, infectious diseases, metabolic and malignant causes. Congenital or inherited ichthyosis is divided into non-syndromic (more common) and syndromic forms (generally ver...
Source: PediatricEducation.org - October 12, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Symptoms of Herpes Simplex Keratitis?
Discussion Herpes simplex virus (HSV) infections are common with an estimated 50% of the US population being infected by age 30, and with latent infection harboring in the trigeminal nerve in 100% of people by age 60 years. HSV infections can cause a vesicular or pustular skin rash that is painful, burning or pruritic and also flu-like symptoms with fever, chills, headache, and fatigue. HSV can also be asymptomatic. To laymen, herpes simplex viruses cause “cold sores,” but to health care personnel, herpes causes many systemic infections including eczema herpeticum, folliculitis, herpes gladiatorum, whitlow, e...
Source: PediatricEducation.org - October 5, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Clinical Signs and Symptoms of Congenital Syphilis?
Discussion Syphilis is caused by the spirochete Treponema pallidum. It is a very old disease that despite understanding the organism and readily available treatment, still causes disease. Syphilis is transmitted sexually. According to the Centers for Disease Control, “[i]n 2018, a total of 35,063 cases of [Primary and Secondary] syphilis were reported in the United States, yielding a rate of 10.8 cases per 100,000 population …. This rate represents a 14.9% increase compared with 2017 (9.4 cases per 100,000 population), and a 71.4% increase compared with 2014 (6.3 cases per 100,000 population).” The incre...
Source: PediatricEducation.org - September 28, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Systemic Disease Causes of Oral Ulcers?
Discussion Oral ulcers are common problems seen by dentists but pediatricians also see them. Usually families have are concerned because they are painful and acute. Ulcers are sometime noticed by the physician and not the family as in the case of herpangina or hand-foot and mouth disease. Chronic or recurrent ulcerations present less commonly and therefore it may be more difficult to determine their etiology. Many of the systemic disease causes of oral ulcers are overall infrequent and/or not common in the pediatric age range. Ulcers can be classified in several ways but acute ulcers are usually painful and last less tha...
Source: PediatricEducation.org - September 21, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is the Allergen Cross-Reactivity Rate of Legumes?
Discussion There are 8 common foods which compromise 90% of food allergens with those being peanuts, soybeans, cow’s milk, eggs, fish, crustacean/shellfish, wheat and tree nuts. Some people believe that lupin (a legume) is 9th. Legumes belong to the Fabaceae family. They provide protein, fat, vitamins other essential nutrients and therefore are used in the human diet throughout the world. “[A]llergenicity due to consumption of legumes in decreasing order may be peanut, soybean, lentil, chickpea, pea, mung bean and red gram.” Other common legumes include alfalfa, clovers, beans, lupins, mesquite, carob...
Source: PediatricEducation.org - September 14, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Is In A Ketogenic Diet?
Discussion Epilepsy is a common problem for the general pediatrician. Its incidence is estimated at 41-87/100,000 children. While many children are controlled with medication, it is also estimated that up to 1/3 will develop drug-resistant epilepsy. Some children may have an identifiable seizure focus that may be amenable to surgery, but many others do not. One option for potential control is a ketogenic diet (KD). Indications for KD usually are for drug-resistant epilepsy including partial and complex seizure patterns as well as some metabolic disorders such as glucose transport 1 deficiency syndrome. It has also found ...
Source: PediatricEducation.org - September 7, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Good Are Face Shields for Preventing Respiratory Infections?
Discussion A scoping review of facial protection for health care workers during a pandemic found that respirators such as N95 masks provide excellent protection against viruses and aerosols especially when combined with eye protection. Mask fit is an important consideration and respirators are tight fitting and therefore much less breathable and comfortable to wear for long periods of time. Surgical masks do not provide as much protection as respirators but are in general more breathable and more comfortable. Surgical masks also provide much more protection than no mask or improvised masks. Improvised masks do provide some...
Source: PediatricEducation.org - August 31, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Are Dental Abscesses Treated?
Discussion Dental caries are one of the most common infections. It is usually caused by Streptococcus viridans. Dental caries are also quite preventable with brushing the teeth at least twice a day with a fluoridated dentifrice, use of dental floss, and preventative dental appointments with application of fluoride varnish and sealants as appropriate. Additionally, fluoridation of the community water supply has significantly decreased dental caries and is a very effective public health measure. Fluoride binds within the dental matrix to strength it. Dental abscesses are usually caused by poor oral hygiene but others are at...
Source: PediatricEducation.org - August 24, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized 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

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