How Old Do You Have to Be To Receive Yellow Fever Vaccine?
Discussion In the United States, Yellow Fever (YF) is rare and usually due to traveler’s coming to the US from Africa (34 countries) or South America (13 countries, see maps here) This wasn’t always true. There were numerous outbreaks in the past few centuries. However, after the Spanish-American War, a YF commission was sent to Cuba that proved YF was mosquito-borne and 1 year later major improvement was seen due to a multi-pronged mosquito control program. “In May 1900, the U.S. Army,…formed the U.S. Army Yellow Fever Commission to gather data in Cuba that might inspire improvements in the publi...
Source: PediatricEducation.org - October 9, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Many Countries Still Have Endemic Wild Polio?
Discussion Poliomyelitis is caused by an enterovirus virus which causes acute flaccid paralysis. It is transmitted through fecal-oral spread. “All three serotypes of WPV [wild polio virus] are highly contagious, although 95% of primary infections cause a transient viraemia [sic] without symptoms. Paralysis occurs in one in 150 infections due to invasion of the central nervous system (CNS) and damage to the anterior horn of the spinal nerve roots.” In the prevaccination era, infants and young children were most at risk. The inactivated (IPV, inactivated or Salk) vaccine and the oral (OPV, live-attenuated or Sabi...
Source: PediatricEducation.org - October 2, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Many Diphtheria Vaccines are Currently Licensed in the US?
Discussion Diphtheria is caused by the toxin produced by Corynebacterium diphtheriae. Two other Corynebacterium species (C. ulcerans and C. pseudotuberculosis) may produce diphtheria toxin; both species are zoonotic. Diphtheria is spread by respiratory droplets and also contact with open ulcers or sores. Incubation period is 1-10 days with a usual period of 2-5 days. The bacteria attacks the respiratory tract mucosa causing cellular death which in turn causes a “pseudomembrane” of tissue to build up causing respiratory distress and possible death due to airway obstruction (5-10% for general population but up to...
Source: PediatricEducation.org - September 25, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Early Fall Break
PediatricEducation.org is taking an early fall break The next case will be published on 9/25/23. 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. (Source: PediatricEducation.org)
Source: PediatricEducation.org - September 18, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Common Vascular Rings and Slings?
Discussion Vascular rings and slings are not that common a congenital heart problem (about 1% of all congenital heart defects), but do occur and arise from abnormal embryological development of the major vascular structures. Embryologically the great vessels and their major branches arise from the aortic sac. The aortic sac forms two horns – a right and a left. These horns then form aortic arches. The aortic arches with their paired branches then course into the pharyngeal arches. Initially these aortic/pharyngeal arches have symmetric vascular pairs, but as development progresses they become asymmetric (basically du...
Source: PediatricEducation.org - September 11, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Complications of Sickle Cell Trait?
Discussion Sickle cell disease (SCD) is a group of inherited blood disorders where there are abnormal hemoglobin molecules and the red blood cells take on a characteristic sickled shape instead of a rounded shape. Sickled hemoglobin provides an evolutionary advantage of giving the individual increased protection against severe and cerebral malaria. The sickled shape doesn’t move through the vascular system as well and therefore is more likely to aggregate in small vessels causing an increased risk of vaso-occlusive disease, acute chest syndrome, splenic sequestration, and priapism. There is also an increased risk of ...
Source: PediatricEducation.org - September 4, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Some Radiographic Signs of Congenital Heart Disease?
Discussion Total anomalous pulmonary venous return causes snowman sign on a chest x-ray. The pulmonary veins fail to connect normally to the left atrium. Alternate pathways direct flow to the right atrium and then across an atrial communication. The admixture of blood at the atrial level and the right to left atrial shunt result in the cyanosis. It may present at birth because of obstruction to the pulmonary veins. “Characteristic heart shapes in patients with congenital heart disease are often due to long standing hemodynamic changes and are therefore less commonly seen today on [chest x-ray] because patients with c...
Source: PediatricEducation.org - August 28, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Underlying Risk Factors for Liver Abscesses?
This study specific excluded patients with ALA or candidemia. LA treatment is usually antibiotics and less invasive surgical techniques such as aspiration or percutaneous catheter drainage, but other treatment including resection is sometimes needed Overall mortality from LA has decreased from 15-40% to as low as 0.8% in the pediatric populations as noted above. Learning Point LA can occur solely because of exposure to infectious organisms but is also commonly associated with hepatobiliary pathology as well. In Northern India study, the “[m]ajority of …children had no predisposing factors for development of LA ...
Source: PediatricEducation.org - August 21, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Can ’ t You Just Do a Hydrogen Breath Test?
Discussion Lactose is a sugar that is commonly found in dairy products. It is digested by the enzyme lactase mainly found on the brush border of the small bowel. Lactase production varies by age and genetics, with infants and young children having a generally higher amount than older children and adults, presumably as they have a more dairy-based diet. There is decreased production starting around 2-3 years of age (i.e. lactase non-persistence). Some people continue to produce lactase at the same levels as infants (i.e. lactase-persistence. “Lactase persistence (lactose tolerance) is seen predominantly in individuals...
Source: PediatricEducation.org - August 14, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Is this a Harlequin Skin Change?
Discussion Harlequins are comic characters originally from the Italian Commedia dell’arte who wore characteristic masks and brightly colored, well-demarcated (outlined) costumes. The comic’s or clown’s costumes vary and many are depicted with diamond shaped patterns. Colors can be predominantly bi-colored or multi-colored. Some costumes will divide the body in half or quarters with each section in a contrasting color or pattern. Pablo Picasso famously painted and sculpted harlequin performers many times in various costumes. Some examples can be seen here. There are at least 3 entities in medicine which us...
Source: PediatricEducation.org - August 7, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Treatments for Recurrent Respiratory Papillomatosis?
Discussion Human papilloma virus (HPV) is a member of the Papillomaviridae virus family with over a 150 different subtypes. HPV can cause cervical, genital and respiratory tract papillomas. HPV is often benign but can cause anogenital, cervical and head and neck cancers. Recurrent respiratory papillomatosis (RRP) is uncommon but can cause significant morbidity while awaiting the body’s immune system to respond. There is a juvenile and adult form, and the incidence varies between 2-4/100,000 in the pediatric population. The juvenile form frequently occurs between 3.6-6 years of age and in general the younger the patie...
Source: PediatricEducation.org - July 31, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news