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

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