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Total 29 results found since Jan 2013.
What Causes Pulmonary Edema?
Discussion
Pulmonary edema is a potentially life threatening condition due to accumulation of excess fluid in the alveolar spaces and walls of the lung.
Patients show increased respiratory effort or distress (e.g. tachypnea, dyspnea or difficulty talking, use of excessory muscles, nasal flaring, tracheal tugging, etc.) and clinicians should beware signs of tiring (e.g. bradypnea and decreased effort) as the patient may be failing. Patients may have rales or rhonchi on pulmonary examination, and pallor or color changes may be noted. Blood gas analysis shows evidence of hypoxemia and often hypercapnia depending on the severi...
Source: PediatricEducation.org - May 15, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Causes of Childhood Interstital Lung Disease?
Discussion
Interstitial lung disease in children (chILD) is less understood than adult interstitial lung disease (ILD) and is rare. Prevalence is ~ 0.13 to 16.2 per 100,000 children under age 17 years. chILD is an general term for respiratory disorders that are heterogeneous, chronic and impair lung function. While some define diffuse parenchymal lung disease (DPLD) separately, the term ILD usually encompases DPLD. chILD has variable definitions and is “usually diagnosed if three of the following features are present:
1) respiratory symptoms (cough, rapid and/or difficult breathing, and exercise intolerance),
2) res...
Source: PediatricEducation.org - August 1, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Rectal Prolapse?
Discussion
Rectal prolapse is defined as a herniation of the rectum through the anal verge. In children it is also usually mucosal prolapse and not full thickness. Partial or mucosal prolapse usually is seen as radial folds occurring 1 – 2.5 cm from the anal verge. Full thickness will protrude more than 5 cm. It affects genders equally and occurs most commonly in children under age 4. This is due to vertical course and low position of the anus, looser supporting tissues and less muscular support. These children are more likely to have prolapse but are less likely to have it recur. After age 4 the rectum takes the adu...
Source: PediatricEducation.org - February 28, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Risk Factors for Bronchopulmonary Dysplasia?
Discussion
Bronchopulmonary dysplasia (BPD) was first described in 1967 by Northway et.al. At that time it was described as “relatively mature preterm infants with severe respiratory failure to survive their initial respiratory distress syndrome after receiving aggressive respiratory support with high oxygen and positive pressure ventilation. Their clinical course was characterized by severe chronic respiratory failure with a radiographic picture showing areas of hyperinflation alternating with adjacent increased densities.” This is often referred to as “Old BPD.”
Over time more has been learned and...
Source: PediatricEducation.org - May 10, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Respiratory Failure?
Discussion The respiratory system is a complex system. The upper airways must remain patient. The lower airways must interface with the vascular system. The musculoskeletal system must provide mechanical function and the central nervous system must provide overall control. Respiratory failure occurs when the overall system cannot support the body’s necessarily ventilation, oxygenation or both. Children are at higher risk of respiratory failure. They have few intrinsic lung parenchyma problems, but have very small airways that increase the airflow resistance by themselves but then have to contend with problems such as...
Source: PediatricEducation.org - December 2, 2019 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Pulmonary Embolism Risk Factors?
Discussion
Pulmonary embolism (PE) is potentially life-threatening but fortunately rare event especially in the pediatric population. It was first described in children in 1861. PE is likely underreported because of minimal or non-specific clinical symptoms. The incidence is estimated at 0.05-4.2% with the 4.2% based on autopsy reports. It is probably also increasing as more central venous catheters (CVC) are used, and more children are surviving previously poor prognostic diseases. There is a bimodal distribution with cases < 1 year (especially neonates which account for ~50% of this group) and in teenagers. Neonates a...
Source: PediatricEducation.org - September 23, 2019 Category: Pediatrics Authors: Pediatric Education 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 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
What is DIOS?
Discussion
Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane receptor (CFTR). It is found in the epithelium of the bronchi, intestine, pancreatic duct and biliary tree. It regulates chloride, bicarbonate and water secretion. The heterozygous state helps prevent against secretory diarrhea, but the homozygous state causes thickened secretions in the hollow tubes of the lungs and digestive tract. There are multiple mutations (> 2000) which have been currently classified into classes depending on their protein production and activity. CF patients generally are l...
Source: PediatricEducation.org - December 18, 2017 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
Dilemma of managing asymptomatic children referred with 'culture-confirmed drug-resistant tuberculosis
Conclusions
Bacteriological evaluation should not be performed in the absence of any clinical indication. If drug-resistant Mycobacterium tuberculosis is detected in an asymptomatic child with a normal chest radiograph, close observation may be an appropriate strategy, especially in settings where potential laboratory error and poor record keeping are constant challenges.
Source: Archives of Disease in Childhood - June 16, 2016 Category: Pediatrics Authors: Loveday, M., Sunkari, B., Marais, B. J., Master, I., Brust, J. C. M. Tags: Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Child health, Radiology, Sexual health, Clinical diagnostic tests, Radiology (diagnostics) Original article Source Type: research
A newborn with severe skeletal dysplasia
We present a newborn boy delivered at 39 weeks gestation with a prenatal diagnosis of skeletal dysplasia. He required endotracheal intubation and mechanical ventilation due to lack of respiratory effort. On physical examination, there was craniotabes, a bell-shaped chest, and brachymelic shortening of all four extremities. Radiographic studies showed lack of mineralisation of the skull except for the base, a small chest with very thin gracile and short ribs, extremely small and segmental regions of unmineralised vertebral bodies, and extremely short, dysplastic long bones with severe rachitic changes (figure 1). Quest...
Source: Archives of Disease in Childhood - Education and Practice - May 17, 2016 Category: Pediatrics Authors: Maalouf, F. I., Coggins, S. A., Phillips, J. A., Stefanescu, B. M., Weitkamp, J.-H. Tags: Immunology (including allergy), Epilepsy and seizures, Pregnancy, Reproductive medicine, Child health, Hospice, Mechanical ventilation, Rheumatology, Metabolic disorders Epilogue Source Type: research
Cow's Milk Allergy and Bone Mineral Density in Prepubertal Children
CONCLUSIONS:
These prepubertal children with persistent CMA had lower lumbar spine BMD z scores than children with NCMA, which likely resulted from lower calcium intake.
Source: PEDIATRICS - May 1, 2016 Category: Pediatrics Authors: Mailhot, G., Perrone, V., Alos, N., Dubois, J., Delvin, E., Paradis, L., Des Roches, A. Tags: Nutrition, Allergy/Immunology Article Source Type: research
QUESTION 1: Should we be using bisphosphonates for osteonecrosis complicating childhood acute lymphoblastic leukaemia?
Scenario A 15-year-old girl with acute lymphoblastic leukaemia (ALL) who has been on high-dose steroids develops a painful right hip. Although plain radiographs are normal, there are changes indicating osteonecrosis on MRI. You remember that osteonecrosis can develop after use of high-dose steroids, and recall a discussion with an orthopaedic surgeon who had said he thought bisphosphonates could help in some patients. You wonder whether they would be of value for your patient. Structured clinical question In a patient with osteonecrosis, presumed secondary to steroid use, in childhood ALL (patient), what is the evidence fo...
Source: Archives of Disease in Childhood - February 18, 2016 Category: Pediatrics Authors: Amin, N. L., James, R. M., Phillips, R. Tags: ADC Archimedes, Oncology, Immunology (including allergy), Pain (neurology), Hypertension, Radiology, Rheumatology, Clinical diagnostic tests, Radiology (diagnostics) Source Type: research
Early introduction of food to prevent food allergy. The LEAP study (Learning Early about Peanut)
Objective: To report a case of a preschool girl who developed acute urinary retention associated with constipation. Case description: A girl aged six years old presented a 24 h history of inability to urinate. She was went twice to the emergency room during this period. In the first admission, 12 h after the onset of the symptoms, she presented abdominal pain and acute urinary retention. After the drainage by urinary catheterization of 300 mL of clear urine, she presented relief of the symptoms and, as urinalysis had no change, the patient was discharged home. Twelve hours after the first visit, she returned to the emergen...
Source: Revista Paulista de Pediatria - January 22, 2016 Category: Pediatrics Source Type: research
