How Do You Treat Immersion Foot Injury?
Discussion
All occupations have some type of potential health consequences. Some are obvious because of the environment such as kitchen workers, first responders, helicopter pilots, etc. Others are may be less obvious or not considered such as slip and falls, cleaning supply chemical exposure, animal bites for postal and utility workers, etc. Noise and lifting objects are often overlooked problems in some settings but obvious in others such as construction. Protective measures, especially appropriate education and training and protective clothing and safety gear are obviously important for performing the work as safely as ...
Source: PediatricEducation.org - July 26, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
When is Post-Operative Bleeding Most Likely to Occur after a Tonsillectomy?
Discussion
Tonsillectomy is one of the most commonly performed surgical procedures in the US with pressure equalizing tubes and circumcisions also being among the top procedures. About 500,000 are performed yearly in the US in children under 15 years. Primary indications are recurrent throat infections (e.g. “< 7 episodes in past year, < 5 episodes in the past 2 years, or < 3 episodes per year in the past 3 years.”) and obstructive sleep apnea.
Potential complications include:
*Pain – treated with ibuprofen or acetaminophen as the first choice and other medications as needed. Pain control also d...
Source: PediatricEducation.org - July 19, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Considerations About Deciding to Send a Child to School
Discussion
For parents there can be a lot of pressure to “get it right” when deciding to send their child to school. Positive adult life outcomes such as employment, physical and mental health, and prosocial relationships are associated with higher educational attainment. Higher educational attainment such as finishing high school and potentially an advanced degree is associated with positive school experiences and domain specific skill attainment (e.g. reading, writing, math skills) and is also associated with readiness to begin school. Therefore if a child is “not ready” to start school, then the ...
Source: PediatricEducation.org - July 12, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Problems are Ciliopathies Associated With?
Discussion
Nephronophthisis (NPHP) one cause of end-stage renal disease (ESRD) usually occurring before age 30 years. NPHP is a non-motile ciliopathy affecting cellular sensing in the renal tubular epithelium. See To Learn More below.
The incidence varies according to location with 1:1 million in the US but 1:50,000 in Finland.
There are 3 subtypes:
Infantile
Occurs usually within 1 year of life
Enlarged kidneys and severe hypertension
In utero can have oligohydramnios problems such as pulmonary hypoplasia, facial dysmorphisms, limb contractures
Extra-renal problems include congenital heart disease, liver fibrosis, recur...
Source: PediatricEducation.org - July 5, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Types of New Therapies are Available for Cystic Fibrosis?
Discussion
Cystic fibrosis (CF) was identified in 1938 by Dr. Dorothy Andersen who described 49 patients with pancreatic insufficiency. Since that time significant achievements in the knowledge about the disease and treatments for patients have changed the mortality from a few months to patients living into middle adulthood or even later. Quality of life for patients and their families and friends has also markedly improved.
CF is the classic Mendelian autosomal recessive genetic disorder which is a worldwide disorder but affects people of north European ancestry more often where the main mutation is more common. There are...
Source: PediatricEducation.org - June 28, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Summertime Break
PediatricEducation.org is taking a summer break. The next case will be published in on June 28th. In the meantime, please take a look at the different Differential Diagnoses, Symptom and Disease listed at the top of the page.
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Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - June 21, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Dacrocystitis in a Teenager?
Discussion
Tears are produced in the lacrimal gland which resides in the upper outer quadrant of the eye. The tears flow across the eye medially and are collected in the superior and inferior puncta which drain into their respective canaliculi, and these drain into a common canaliculus. Tears then pass through the valve of Rosenmuler into the lacrimal sac where they are collected. Tears then pass through the nasolacrimal duct, through the distal valve of Hasner and into the nasal cavity. Vascular connections are extensive in this anatomic area and veins do not have valves. Therefore infections can spread easily through dir...
Source: PediatricEducation.org - June 14, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Some Indications for Using Dexamethasone?
Discussion
Corticosteroids are a group of drugs which can be naturally or synthetically produced. Naturally occurring substances are produced in the adrenal gland, and are protein-bound (primarily corticosteroid-binding globulin and albumin). In the target tissues, they may need to be converted to an active substance. They are then reduced, oxidized, hydroxylated or conjugated as measures to inactivate them. Synthetic steroids have less protein binding and depending on their structure are more or less resistant to inactivation. Prednisone is the glucocorticoid most often used for treatment, especially as it has a short hal...
Source: PediatricEducation.org - June 7, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Which Premature Infants Need Eye Exams?
Discussion
Retinopathy of prematurity (ROP) is a developmental problem. Term infants have full vascularization of the retina and therefore cannot have ROP. Premature infants however do not have full vascularization (which proceeds from the periphery to the central retinal area) and therefore may have abnormal and excessive vascularization. It affects premature infants primarily < 31 weeks gestation. Although the mechanism of ROP is not completely understood, increased oxygen levels are a risk factor. Additionally there is data which shows growth factors such as vascular endothelial growth factor (VEGF) are increase,d re...
Source: PediatricEducation.org - May 31, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Common are Co-infections with Trichomonas and Bacterial Vaginosis?
Discussion
Vulvovaginitis is a common gynecological complaint for females of all ages. It is specifically the inflammation of the vulva and vagina but is used as a general term often to mean vulvar irritation, itching, and burning that can occur with or without vaginal discharge. In prepubertal females there is lack of estrogenization, and less lactobacillus species which creates a more neutral pH (normal vaginal pH is < 4.5), lack of pubic hair and fat pad which provide trauma protection, location of anus close to the vagina and tendency of poor hygiene in young children. With puberty, estrogen thickens the vaginal tis...
Source: PediatricEducation.org - May 24, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What are Common Causes of Anaphylaxis?
Discussion
Anaphylaxis is a potentially life-threatening hypersensitivity reaction of the body. Usually anaphylaxis is IgE mediated but complement-mediated immune complex reactions or IgG mediated reactions can cause anaphylaxis. Usually mucous membranes or skin are involved, but it is a systemic disease process with at least 2 systems involved (respiratory is second most common followed by gastrointestinal system). The epidemiology is difficult to discern but the estimated incidence is about 50-112 episodes per 100,000 person-years and estimated prevalence is 0.3-5.1%. There is data supporting an increased incidence. Over...
Source: PediatricEducation.org - May 17, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Risk Factors for Bronchopulmonary Dysplasia?
Discussion
Bronchopulmonary dysplasia (BPD) was first described in 1967 by Northway et.al. At that time it was described as “relatively mature preterm infants with severe respiratory failure to survive their initial respiratory distress syndrome after receiving aggressive respiratory support with high oxygen and positive pressure ventilation. Their clinical course was characterized by severe chronic respiratory failure with a radiographic picture showing areas of hyperinflation alternating with adjacent increased densities.” This is often referred to as “Old BPD.”
Over time more has been learned and...
Source: PediatricEducation.org - May 10, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Some Etiologies for Intellectual Disability?
Discussion
“Intellectual disability (ID) is a neurodevelopmental disorder that is characterized by deficits in both intellectual functioning and adaptive function whose onset is in the development period.” Global developmental delay (GDD) is used to describe children from 0-5 years old with significant delays in 2 or more developmental areas. These delays may be transient but up to 2/3 of children with GDD will have ID. Overall 1-3% of the general population has ID which makes it very common.
Most children with GDD/ID are identified because of delays in meeting milestones or general academic achievement. ID pat...
Source: PediatricEducation.org - May 3, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Are There Developmental Changes in Platelet Function for Children?
Discussion
While most people realize that each stage of a child’s life is different, there are some areas that people do not realize are different. For example, there are many laboratory values which are different based on the age because there are developmental changes. Within the hematopoietic system there are many developmental changes that are common such as hemoglobin and hematocrit. Others are less well known such as children have quantitatively less fibrinogen, but the activity is the same as adult fibrinogen.
Platelets are an important part of both the primary and secondary hemostasis processes. They develop ...
Source: PediatricEducation.org - April 26, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
How Are Iliac Fractures Treated?
Discussion
Avulsion fractures of the pelvis are more commonly seen in adults and teenage athletes. Currently they are more common in male athletes but with the increased number of females in sports, more are also being seen in females. Soccer and track and field are common sports where these injuries occur. The injuries are felt to be caused by a repetitive traction on the apophysis or more commonly due to a ‘sudden, forceful, or unbalanced contraction of an attached musculotendinous unit while engaged in a sporting event…. Skeletal maturity has a direct effect on the incidence of the injury.” They can oc...
Source: PediatricEducation.org - April 19, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
