What Causes Parotitis?
Discussion The salivary glands are important for creating saliva which helps with taste, digestion, oral health, and speech. Salivary gland problems are not that common but can be painful, annoying or herald potential systemic diseases. The parotid gland is the largest salivary gland lying anterior to the ear within the cheek structures. There are 2 lobes (superficial and deep) and the facial nerve runs between them. The salivary duct opens adjacent to the upper second molar. Infections are the most common cause of parotitis with mumps being the most commonly associated infection especially in unimmunized patients. Patient...
Source: PediatricEducation.org - April 10, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Immunity Do Breast Milk Antibodies Confer?
Discussion Breast milk (BM) has many benefits including its primary role providing appropriate nutrition for newborns and infants, which includes making those nutrients more bioavailable. While BM does not provide all of the nutritional needs over the entire year or two of breastfeeding, complimentary foods are important for furnishing additional nutritional needs along with helping development of appropriate taste and texture acceptance, along with oral-motor skills. Complimentary foods are recommended by the American Academy of Pediatrics when the infant is developmentally ready which is commonly after 6 months of life. ...
Source: PediatricEducation.org - April 3, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What are Presentations of Neuroblastoma?
Discussion Abdominal pain is a very common problem with abdominal masses being somewhat less common. If one considers how frequently patients have abdominal pain due to constipation and that it often presents with a fecal mass, both of these are commonplace. Abdominal and pelvic organs are sometimes mistaken for masses also. As the abdominal and pelvic cavities are large, tumors often need to be quite large before they cause functional problems and/or can be palpated on physical examination. A review of abdominal masses can be found here. A review of recurrent abdominal pain can be found here. A review of acute abdominal p...
Source: PediatricEducation.org - March 27, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Presentations of Neurocysticercosis?
Discussion Neurocysticercosis (NCC) is the most common parasitic CNS infection world-wide. It is caused by the larval stage of the pork tapeworm Taenia solium. It is endemic in Southeast Asia including the Indian Subcontinent, sub-Saharan Africa and Latin America. It is becoming more common in other areas of the world because of immigration and the overall ease of travel. The basic Taenia lifecycle is that humans eat un- or undercooked pork (pigs are the intermediate host) that is invested with the larvae called cysterici. The adult tapeworm forms in the human gastrointestinal tract and eggs are produced. Humans are the de...
Source: PediatricEducation.org - March 20, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Does Ebstein ’ s Anomaly Present?
Discussion Ebstein’s anomaly (EA) accounts for about 0.3-0.5% of all congenital heart disease and about 40% of all tricuspid valve (TV) pathologies. It was first described by Dr. William Ebstein in 1866. In EA’s simplest form, the TV is displaced inferiorly from the normal hinge points into the right ventricle (RV). This is caused by delamination of both the septal and mural leaflets and they usually form a combined leaflet which can be more adherent to the RV. These anatomical changes causes poor movement of the leaflet(s) and tricuspid regurgitation. Displacement inferiorly can cause decreased RV capacity and...
Source: PediatricEducation.org - March 13, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Winter Break
PediatricEducation.org is taking a short break. The next case will be published on March 13th. 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 6, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is PAN?
Discussion Vasculitis is an inflammation of the blood vessels. Often, the term implies the arterial vessels, but venous and capillary vessels can be affected. The nomenclature to describe vasculitis and its classification have varied over time. Arterial vessel size is one method and some more common entities include: Small vessel, mainly Granulomatous – granulomatosis with polyangiitis (aka Wegener’s granulomatosis), eosinophilic granulomatosis with polyangiitis (aka Churg Strauss syndrome) Nongranulomatous – Henoch-Schonlein purpura (HSP), microscopic polyangiitis Medium vessel, mainly Childhood sys...
Source: PediatricEducation.org - February 27, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Mediastinal Masses?
Discussion The mediastinum resides in the chest and is the space bounded by the thoracic inlet cephalically, diaphragm caudally, sternum anteriorly and transverse process of the spine posteriorly, and mediastinal pleura and lungs laterally. It is divided into various compartments: Superior mediastinum Bounded by the thoracic inlet cephalically and a horizontal plane passing from the manubriosternal joint to the junction of T4/T5 vertebrae horizontally. Structures include: esophagus, trachea, parts of great vessels and first branches, great veins and initial branches, thymus, vagus, phrenic and other nerves, thoracic duct...
Source: PediatricEducation.org - February 20, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Meconium: It Can Cause a Sticky Mess
Discussion During fetal life from approximately 12-13 weeks gestation, meconium accumulates in the small bowel and migrates to the large bowel and rectum by ~20 weeks gestation. Meconium is a combination of bile, mucous, desquamated intestinal cells, bowel secretions, dessicated swallowed amniotic fluid and lanugo. It is sterile before birth and once produced is odorless with a blackish green (sometimes brown or yellow) color, and tarry or sticky quality. Defecation does not occur during fetal life unless the fetus is significantly stressed. Normal meconium passage after birth occurs within 24-48 hours of life (more often ...
Source: PediatricEducation.org - February 13, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Laboratory Tests Are Consistent with Transient Erythroblastopenia of Childhood?
Discussion Transient erythroblastopenia of childhood (TEC) is an “…anemia with a hemoglobin level at least 2 [standard deviations] below normal and a low reticulocyte count in relationship to the anemia in the absence of evidence of alternative causes of anemia.” A bone marrow aspirate shows decreased or absent erythroid precursor cells if obtained. The etiology is not well understood but may have a stimulating cause such as a viral infection, an immune-related and/or genetic cause. Parvovirus causing bone marrow suppression has been implicated and there are cases of affected siblings. TEC is most common ...
Source: PediatricEducation.org - February 6, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Good is Cholecystectomy For Biliary Dyskinesia in Pediatric Patients?
Discussion Biliary disease includes gallstones, cholecystitis (inflammation of the gallbladder), cholangiopathy and cholangitis (pathology of the bile ducts), biliary dyskinesia, gangrene, and cancer. Some are often overlapping as gallstones often contributing to cholecystitis and cholangitis. Biliary dyskinesia (BD) is well-recognized in adults. Adult criteria include: “abdominal pain located in the epigastrium and/or right upper quadrant along with; buildup of pain to a steady level and lasting 30 minutes or longer, pain occurring at different intervals and not daily, severe enough to interrupt activities or lead t...
Source: PediatricEducation.org - January 30, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Potential Treatments for Hyperacusis?
Discussion Hearing is functional in human fetuses at approximately 25-27 weeks gestation.. The aural anatomical structures are developed by ~32 weeks gestation. Hyperacusis does not have a specific definition but in general is an increased sensitivity to sounds (either intensity or loudness). Some authors describe it as “…decreased sound tolerance where there is a negative reaction to the physical characteristics of the sound,” and other authors use “…increased sensitivity to sound in levels that would not trouble a normal individual.” Phonophobia is a true fear of sounds with anticipati...
Source: PediatricEducation.org - January 23, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are Common Dietary Fermentable Carbohydrates?
Discussion Parents may often come to the pediatrician for concerns about crying and colic, increased belching, abdominal distention, increased flatulence, abdominal pain or stool changes. They complain of increased “gassiness,” which could mean any or a combination of these problems, or something different that they believe is referred to the abdomen. In newborns parents’ intolerance for crying and normal changes in the abdomen (e.g. appearing larger or smaller) may have them complain of “gassiness” but they do not mean actual belching or flatulence. In older children, parents may state that t...
Source: PediatricEducation.org - January 16, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What is An Emotional Support Animal?
Discussion Humans have had animals in their lives for millennia. Domesticated animals have been used for work, food, protection, and companionship among other activities. Dogs are a common species that are trained for a myriad of tasks including providing therapeutic benefits to persons with permanent or temporary disabilities including persons with psychiatric problems. The utilization of animals in medical/psychiatric therapeutic treatment programs is known as animal assisted activities (AAA) and animal assisted therapy (AAT). These programs have at least a 225-year history of being used. AAA tend to focus on recreation ...
Source: PediatricEducation.org - January 9, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Happy Holidays
PediatricEducation.org is taking a year end break and will return on January 9, 2023. We wish everyone a happy and safe holiday season and all the best in the New Year. 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 - December 26, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news