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
Spring Break
PediatricEducation.org is taking a short break. The next case will be published on March 25. 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. (Source: PediatricEducation.org)
Source: PediatricEducation.org - March 18, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How Common Is Unintentional Cannabis Ingestion?
Discussion
“[Cannabis] is a genus of flowering plant with three main varieties: sativa, indica and ruderalis.” It has been used for hundreds of years for hemp or fiber and also for psychoactive and medicinal effects. The active compounds are collectively called cannabinoids, of which delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most abundant. The floral buds or calyxes of the plant have the most cannabinoids, but other parts of the plant are also used such as leaves. Hash oil, hashish (or resin) and marijuana (dried leaves) are the common products from strongest to least strongest products. ...
Source: PediatricEducation.org - March 11, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Are the Types of Tracheoesophageal Fistulas?
Discussion
Respiratory problems in infants can caused by many things including any type of obstruction from the nose to lung. Neonates and infants are particularly susceptible to changes in the size of the airway because of the physics of airflow resistance. Important reminders about infant airways:
Resistance = 1/radius4 (Poiseuille’s equation) therefore even a 1 mm decrease in the airway circumferences increases the airflow resistance x16.
Increased airflow causes less pressure along the walls, which can lead to collapse of the walls (Bernoulli’s and Venturi effects).
Neonates have smaller lungs relative to ...
Source: PediatricEducation.org - March 4, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Is the Most Common Type of Cardiomyopathy?
Discussion
Barth syndrome is characterized by a dilated cardiomyopathy, proximal skeletal muscle weakness, neutropenia and short stature that usually presents at birth or soon after. It is a rare X-linked recessive disease process caused by mutations in the TAZ gene. The TAZ gene codes for tafazzin which alters cardiolipin in mitochondria. Characteristic facies can be seen especially in infancy including a tall and broad forehead, prominent chin and full cheeks, larger ears, and deep-set eyes. Most patients present at birth or soon afterwards but some may not until later in life. Life expectancy is reduced with many childr...
Source: PediatricEducation.org - February 25, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How Common is Bipolar Disorder?
Discussion
Bipolar disorder (BD) is a chronic, recurrent, affective disorder with fluctuations in energy and mood. “Bipolar disorder, previously known as manic depressive illness, is a severe chronic mood disorder characterized by episodes [note not just one instance] of mania, hypomania, and alternating or intertwining episodes of depression.” Affective disorders are classified based on their severity and extent, from unipolar to BDII to BDI. “Individuals with unipolar disorder present with depressive episodes only, and those with bipolar II or I disorder show increasingly pronounced episodes of mood ele...
Source: PediatricEducation.org - February 18, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Should You Do About Head Banging?
Discussion
Head banging and body rocking are common habits that young children exhibit that can be worrisome or frustrating for parents but that do not cause harm to the child. In a normally developing child they occur around 6-9 months age, and generally resolve around 2-3 years with most behaviors gone by 6-8 years. Children usually do not cause harm to themselves, but it can cause furniture to move causing noise, or potentially the child could lose balance and fall off a bed, or strike an object unintentionally and hurt themself (hit edge of a bed just right in a way that causes a small bruise). The behaviors appear to ...
Source: PediatricEducation.org - February 11, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How Common is Dyscalculia?
Discussion
Numerical understanding is imperative in everyday life. Even making coffee in the morning, a person considers whether she is making 1 cup or 2, and how much fluid will be in each cup. How many more days can she go without buying more coffee with the ground coffee left in the container? Other numerical skills such as telephone numbers, street addresses and locations, time and dates, and buying and selling of products and services occur all day long in people’s lives. What happens when those skills are not automatic?
Dyscalculia or developmental dyscalculia (DD) is “a heterogeneous learning impairment...
Source: PediatricEducation.org - February 4, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Are Common Causes of Blindness in Children?
Discussion
According to the World Health Organization, about 1.3 billion people have some form of visual impairment. Most people with visual impairments are >50 years old, more are female than male, and more live in resource-limited areas than resource-rich areas. Most visual impairments are avoidable (80%) in all age groups with the leading causes globally and across ages being uncorrected refractive errors and cataracts.
The most common causes of blindness are:
Refractive errors, uncorrected
Cataract
Age-related macular degeneration
Glaucoma
Diabetic retinopathy
Corneal opacity
Trachoma
The exact numbers vary by reg...
Source: PediatricEducation.org - January 28, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Complications Can Gastrostomy Tubes Have?
Discussion
Gastrostomy tubes (GT or GTubes) have been used to support patients for about a century. They are placed between the abdominal skin and the stomach either percutaneously or surgically. The tubes can be a standard long tube with either a bumper or inflatable balloon internally and externally they have a retention piece to hold the GT in place. A button or low profile tube are similar but extend just beyond the skin.
Reasons for GT placement include:
Nutritional support
Hydration maintenance
Medication management
Aspiration avoidance
Gastric stasis decompression
Obstruction bypass
Quality of life improvement for...
Source: PediatricEducation.org - January 21, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Are Potential Complications of Large for Gestational Birthweight?
Discussion
Infant size at birth is determined mainly by genetics, but also pregnancy and environmental factors. Large for gestational age (LGA) is defined as a mean weight > 2 standard deviations above the weight for gestational age or above the 90th percentile on growth charts (or ~4000 g on WHO growth charts). Macrosomia is a term used for a term infant who is > 4000g.
Risk factors for LGA infants includes:
Male infant
Maternal
Genetic disposition
Hispanic ethnicity
Diabetic
Multiparity or grand parity
Obesity
History of previous LGA infant
Prenatal ultrasound is very helpful for antenatal management. First t...
Source: PediatricEducation.org - January 14, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Are The Potential Complications of a Tracheostomy?
Discussion
In the past, indications for tracheostomy were often because of infection, but today are more often due to need for chronic airway support and/or ventilation. Many more children and infants are having tracheostomies placed. Decannulation rates for these children are low due to concomitant complex chronic disease such as neurological, pulmonary and congenital heart diseases. Co-morbidies are common with 3-4 being average, and frequently also including chronic technology such as gastrostomy tubes or ventriculoperitoneal shunts. Approximately 8% of children do not survive the hospitalization where the tracheostomy ...
Source: PediatricEducation.org - January 7, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
Holiday Break
PediatricEducation.org will be taking a holiday break and wishes our patrons a Merry Christmas and healthy New Year.
The next case will be published on January 7th. In the meantime, please take a look at the Archives and Curriculum Maps listed on the right side of the page.
We appreciate your patronage,
Donna D’Alessandro and Michael D’Alessandro, curators. (Source: PediatricEducation.org)
Source: PediatricEducation.org - December 24, 2018 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What Causes Hyperpigmentation?
Discussion
Skin color is primarily due to genetic factors. Melanocytes are usually found in skin in the basal layer of the epidermis which is also where the melanin usually lies. There are a range of normal skin phenotypes that have been described by Fitzpatrick and range from I-VI:
I – pale white skin, blond hair, blue eyed, does not tan, always burns
II – fair skin, blue eyed, tans poorly, burns easily
III – darker white skin, burns initially then tans
IV – light brown skin, tans easily, burns minimally
V – brown skin, tans darkly easily, burns rarely
VI – dark brown skin, alway...
Source: PediatricEducation.org - December 17, 2018 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
What are Some of the Causes of SGA?
Discussion
Intrauterine growth retardation or fetal growth retardation is due to a pathological process that causes decelerated fetal growth velocity. Small-for-gestational age (SGA) is an infant with growth parameters below the normal range for gestational age. More commonly, SGA is defined as a birth weight < 10% for gestational age. This may be due a pathological or non-pathological process (e.g. constitutionally small fetus). Using these standards, remember that 10% of all infants will be < 10% for weight, and they do not necessarily have an underlying problem and infants who are constitutionally small do not hav...
Source: PediatricEducation.org - December 10, 2018 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
