What Infectious Diseases are Important to Consider in Transplantation Patients?
Discussion
Transplantation is not a common problem for primary care physicians but when a child’s disease has progressed to end-stage organ failure, transplantation can be the only treatment available. While the primary care provider usually is not involved in the daily management of patients before, during and after transplantation, they can be involved in many areas. These can include providing appropriate primary and acute care, ordering and obtaining necessary medical tests, medications and equipment, assisting with medical insurance, providing medical history and records to consultants, translating medical infor...
Source: PediatricEducation.org - June 24, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What is the Morbidity Rate for Smoke Inhalation?
Discussion
A recent systematic review of house fires in high-income countries found that the risk factors for unintentional house fire incidents included: more children under 5 years of age, more people in the home, more males in the home, adults who are not working, low-income, household smokers, non-privately owned housing, poor condition housing. Other risk factors are not having smoke detectors, but more importantly not having a working smoke detector.
Risk factors for injuries or fatalities is similar to the the risk factors for incidents but also includes people who are vulnerable such as a disabled resident, someon...
Source: PediatricEducation.org - June 17, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How Common is Restless Legs Syndrome in Children?
Discussion
Restless legs syndrome (RLS) is also known as Willis-Ekbom disease.
RLS is a clinical diagnosis with criteria being:
1. An urge to move the legs usually accompanied by uncomfortable and unpleasant sensations in the lower extremities (Note: sometimes other body parts can be affected)
2. The urge to move begins or worsens when sitting or lying down
3. The urge to move is partially or totally relieved by movement (Note: relief by activity may not be noticable if severely affected but must have been previously present)
4. The urge to move the legs and any accompanying unpleasant sensations during rest or in activ...
Source: PediatricEducation.org - June 10, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Causes Facial Nerve Palsy?
Discussion
Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - June 3, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Causes Temporomandibular Joint Problems?
Discussion
The mandible normally grows in a symmetric downward and forward movement relative to the skull base. The condyle is the primary growth center. “The mandible is unique in that its 2 joints and growth centers function together as a single unit.” It is the last bone in the body to reach skeletal maturity. The mandible and its growth are important for maxillary growth and therefore many problems that affect the mandible affect the facial and skulls structures as well. These growth problems can be relatively insidious and therefore may need monitoring over longer periods of time such as patients with unde...
Source: PediatricEducation.org - May 27, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Causes Macrocephaly?
Discussion
“Macrocephaly is defined as [an occipitofrontal circumference or head circumference, OFC ] of > 2 standard deviations above the mean or above the 97th percentage for a given age, and gender, or when serial measurement shows progressive enlargement, crossing of one or more major percentiles, or when there is an increase in OFC > 2 cm/month in the first 6 months of life.” Megalencephaly is enlargement of the brain parenchyma. The OFC should be measured using a non-elastic tape which surrounds the head along the line of the glabella and posterior occipital protrusion.
There are ethnic differences...
Source: PediatricEducation.org - May 20, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Are Barriers and Facilitators of Transitioning Youth to an Adult Health Care Provider?
Discussion
Transitioning patients within or across health care facilities is a complex process. It is not a single step or point in time. For many patients the transition from pediatric to adult health care can be uncomplicated as patients and health care providers are ready for the transition and are seeking it. It should be a part of “developmental milestone” for adolescent visits. Asking adolescents about their future plans especially after high school or college often easily segues into this discussion easily. For other patients and families, there is anxiety and fear about the transition process. For yout...
Source: PediatricEducation.org - May 13, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
Is This Sarcoidosis?
Discussion
Sarcoidosis is rare and is even rarer in the pediatric age group. Sarcoidosis is seen in all ages with an estimated prevalence is 10-40/100,000 in the U.S. population. Pediatric sarcoidosis has an estimated incidence of 0.2/100,000 per year. For the pediatric age range it is more likely from 9-15 years of age. In adults it commonly presents between 20-39 years but bimodal distribution is also reported. Women are more likely to have sarcoidosis than men. African American females have the highest risk, and usually present slightly older, especially in the 4th decade of life. African American women are also more li...
Source: PediatricEducation.org - May 6, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Clinical Symptoms Can An Infant with Polycythemia Have?
Discussion
Polycythemia is defined as a venous hematocrit of > 65% or a venous hemoglobin of > 22 g/dL. Capillary values are unreliable and any values greater than normal should be repeated with a venous sampling for confirmation. Hyperviscosity is distinct from polycythemia and “… is defined as a viscosity greater than 14.6 cP at a shear rate of 11.5 per second, or a value 2 standard deviations above the mean.” Hyperviscosity is difficult to measure in the clinical setting therefore polycythemia is often used as a proxy.
Polycythemia occurs in about ~1.5-5% of births. Risk factors for it includes...
Source: PediatricEducation.org - April 29, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Are Some Potential Indicators of Human Trafficking?
Discussion
Human trafficking is estimated to be the second largest criminal activity in the world after illegal arms trafficking. It affects all nations with an estimated 27 million people of all ages worldwide but only a small number are identified. It is defined by the United Nations as “the recruitment, transfer, harboring, or receipt of persons by means of threat or use of force or other forms of coercions, abduction, fraud, deception, the abuse of power, or a position of vulnerability to achieve the consent of a person, having control over another person, for the purpose of exploitation.” It includes comme...
Source: PediatricEducation.org - April 22, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How Commonly Are Brain Tumors Seen in Spasmus Nutans?
Discussion
Nystagmus is periodic eye movement that is involuntary where there is a slow drift of fixation. The slow drift can be followed by a fast saccade back to fixation. The pathological movement is the slow phase, but nystagmus is described by the fast phase (i.e. horizontal nystagmus, vertical nystagmus).
Spasmus nutans (SN) is a movement disorder that is rare. The classic triad includes nystagmus, head bobbing or titubation, and torticollis, with these problems being in the absence of any ophthalmological or neurological condition. Onset is in the first year of life but ranges from 6-36 months. Time to resolution ...
Source: PediatricEducation.org - April 15, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How Common Are Brain Tumors Seen in Spasmus Nutans?
Discussion
Nystagmus is periodic eye movement that is involuntary where there is a slow drift of fixation. The slow drift can be followed by a fast saccade back to fixation. The pathological movement is the slow phase, but nystagmus is described by the fast phase (i.e. horizontal nystagmus, vertical nystagmus).
Spasmus nutans (SN) is a movement disorder that is rare. The classic triad includes nystagmus, head bobbing or titubation, and torticollis, with these problems being in the absence of any ophthalmological or neurological condition. Onset is in the first year of life but ranges from 6-36 months. Time to resolution ...
Source: PediatricEducation.org - April 15, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Are Treatment Options for Pediatric Onycomycosis?
Discussion
Onycomycosis is a fungal infection of the nails. It has a world-wide prevalence of 0.3% with some geographical variations such as in the U.S. it is 0.44%. It is an uncommon problem especially in children. It is very uncommon in those under 6 years and only very sporadic case reports in those under 2 years. The lower incidence is felt to be due to children’s faster nail growth, smaller surface to infect, reduced exposure to fungi, lower prevalence of tinea pedis and especially less cumulative trauma. Onycomycosis is more common in families (unsure if this is due to genetic factors or family members having m...
Source: PediatricEducation.org - April 8, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Does the Liver Do?
Discussion
The liver is one of the largest organs in the body, weighing just over 3 pounds in an adult. It is found in the upper right abdomen, under the right dome of the diaphragm. Grossly, it has asymmetric lobes with the right being larger than the left. The lobes are separated by a fibrous connective tissue band that also anchors the liver in the abdominal cavity. The gallbladder is located on the inferior surface of the liver and stores bile, which is then released into the duodenum. Microscopically, the liver cells are arranged in lobules with canals carrying blood vessels and bile ducts. At any moment about 10-13% ...
Source: PediatricEducation.org - April 1, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How Long Does Fecal Shedding Occur for Oral Vaccines?
Discussion
Vaccination has reduced infectious disease morbidity and mortality since its introduction. Vaccines can be given intramuscularly, subcutaneously or orally. Oral virus vaccines currently used in the US include rotavirus, cholera, typhoid and adenovirus. Adenovirus vaccine is used in military personnel. As these are attenuated viruses there is concern for household contacts who are immunocompromised who may inadvertently be exposed to the virus through fecal shedding. Additionally, there is a concern that the attenuated virus may mutate and revert back to its wild-form and potentially cause disease.
Injectable po...
Source: PediatricEducation.org - March 25, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
