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Is This Primary Exertional Headache?
Discussion Commonly occurring primary headaches include tension, cluster and migraine headaches. “Other primary headaches” are often situational. Patients can have more than 1 type of these “other” headaches along with more common headaches. Other primary headaches as a group tend to be self-limited with long remission periods. Some other primary headaches include: Thunderclap headache Explosive sudden onset with maximum intensity in less 1 minute and resolution within 5 minutes usually 43/100,000 persons in adults Primary or secondary Secondary causes include intracranial hemorrhage, stroke, thro...
Source: PediatricEducation.org - November 21, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Common are Aortic Aneurysms?
Discussion Aortic root dilatation or thoracic aortic aneurysm occurs in 6:100,000 individuals > 50 years of age. It is due to aging, hypertension, hypercholesterolemia, and smoking. Tertiary syphilis was a cause in the preantibiotic era. Pediatric aneurysms are very uncommon but the exact prevalence is different due to the various causes. Aneurysms are due to genetic disorders, congenital anomalies or post-surgical repair. In pediatric patients with sudden cardiac deaths, 5.4% are due to ruptured thoracic aortic aneurysms. Learning Point Some causes of pediatric aneurysms include: Familial thoracic aneurysm and dissect...
Source: PediatricEducation.org - February 22, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Good is Photoscreening For Young Children ’ s Vision Problems?
This study showed that not only was smartphone photoscreening feasible, but was quite good at screening for potential vision problems. Smartphone photoscreening has the advantages of being more ubiquitously available and thus children in almost any location can be screened. A study of photoscreening using a handheld digital photoscreener in primary care offices validated the technology showing an overall referral rate of 10% to an ophthalmologist with suspected astigmatism, anisometropia and strabismus being the most common reasons. The overall positive predictive rate was 0.60. “…[O]ver 60% of children referre...
Source: PediatricEducation.org - January 4, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Main Acyanotic Congenital Heart Diseases?
Discussion Congenital heart diseases (CHD) are malformations of the heart and great vessels. It occurs in about 5-8/1000 live births. Cyanotic congenital heart disease is often noted perinatally because of cyanosis, respiratory distress and/or poor feeding or other distress type problems. A review can be found here. Acyanotic congenital heart disease (ACHD) can present at birth but often is seen in older children or adults unless the lesions are severe, especially obstructive lesions. Severe lesions may also cause cyanosis and distress type problems in patients also. Shunting lesions cause problems by diverting blood flo...
Source: PediatricEducation.org - August 17, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Hyperammonemia?
Discussion Reye’s syndrome (RS)is named for Dr. Douglas Reye who along with Drs. G. Morgan and J. Baral described encephalopathy and fatty accumulation and degeneration in children in a 1963 Lancet article. RS usually affects children but can occur at all ages. All organs can be affected but the liver and brain are primarily affected causing liver failure and encephalopathy as toxic metabolites (especially ammonia) accumulate, and intracranial hypertension and cerebral edema occurs. As the ammonia levels begin to rise (> 100 mg/dL) patients lose their appetite, have nausea and emesis and mental status changes whic...
Source: PediatricEducation.org - February 20, 2017 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Public health for paediatricians: population screening
Introduction The concept of population screening—proactive identification of a condition, disease or predisease state in individuals who presume themselves to be healthy but may benefit from early treatment—is a simple one. The translation of this into a screening programme often raises ethical, conceptual and practical challenges. For clinicians used to dealing with patients symptomatically, there are several key differences to understand between treating patients symptomatically compared with the approach to supporting the delivery of a screening programme. There is a range of definitions of screening, which ...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2016 Category: Pediatrics Authors: Streetly, A., Madden, V. Tags: Drugs: CNS (not psychiatric), Stroke, Hypertension, Pregnancy, Reproductive medicine, Child health, Neonatal health, Screening (epidemiology), Health promotion, Screening (public health) Source Type: research

Different stroke(s)
A 13-year-old boy with mild learning difficulties presented to his district general hospital after an unwitnessed episode of collapse with vomiting but no loss of consciousness. He had 3 days of lethargy and intermittent occipital headaches waking him from sleep. Two days later, after another ‘funny turn’, he represented with right-side paraesthesia, weakness and word-finding difficulty. He had three previous ‘collapses’ over the last 6 months, including symptoms of transient dizziness, slurred speech, dribbling, difficulty swallowing and left-facial paraesthesia from which he had recovere...
Source: Archives of Disease in Childhood - Education and Practice - May 17, 2016 Category: Pediatrics Authors: Mundada, V., Krishnakumar, D., Chitre, M., Das, T. Tags: Oncology, Eye Diseases, Drugs: cardiovascular system, Echocardiography, Headache (including migraine), Infection (neurology), Neurooncology, Pain (neurology), Stroke, Hypertension, Ophthalmology, Valvar diseases, Radiology, Rheumatology, Dermatology, Clin Source Type: research

Hypothermia did not improve mortality or disability in severe traumatic brain injury
Study design Design: Randomised controlled trial (RCT). Allocation: Concealed web based algorithm to stratified by study site and age. Blinding: Treating doctors not masked—investigators assessing outcome were masked. Study question Setting: Multinational, multicentre paediatric intensive care unit—75% patients from three paediatric intensive care units (Davis, California; Dallas, Texas; Pittsburgh, Pennsylvania) in USA. Patients: Age 0–17 years non-penetrating brain injury; Glasgow coma scale (GCS) score 3–8 (motor score <6), available for randomisation within 6 h of injury. Excluded i...
Source: Archives of Disease in Childhood - Education and Practice - May 14, 2014 Category: Pediatrics Authors: Tasker, R. C. Tags: Clinical trials (epidemiology), Epidemiologic studies, Coma and raised intracranial pressure, Neurological injury, Stroke, Hypertension, Pregnancy, Reproductive medicine, Child health, Neonatal and paediatric intensive care, Neonatal health, Trauma, Injur Source Type: research

When Can A Child Start Strength Training?
Discussion Exercise is an important part of health and daily life. A review of recommendations for general exercise for children and adults can be found here. Many people use pedometers as a marker of their activity and a list of activities and their equivalent steps can be found here. The benefits of strength training includes improved performance, injury prevention and rehabilitation, improved cardiovascular fitness, improved bone mineral density, improved blood lipid profiles and mental health. Improvements in strength can be found in properly structured programs of at least 8 weeks duration occurring at least 1-2 time...
Source: PediatricEducation.org - May 12, 2014 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news