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Total 26 results found since Jan 2013.
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
Can Patent Foramen Ovales Cause Problems?
Discussion
During fetal development, the heart primum and secundum septa grow and overlap leaving a small but important channel between the two atria. The foramen ovale is a flap valve moving blood from the right atrium into the left atrium directly and bypassing the high pressure pulmonary system. After birth and breathing air, the neonate’s lungs open up and the pulmonary vascular resistance decreases. The left atrium now has a relatively higher pressure than the right atria, and therefore pressure on the flap valve closes the foramen ovale. Usually within 6-12 months, the fusion of the primum and secundum of the f...
Source: PediatricEducation.org - July 24, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are the Classifications of Perinatal Stroke?
Discussion
Perinatal stroke occurs in about 1:1000 live births and is a “focal vascular injury from the fetal period to 28 days postnatal age.” Perinatal stroke is the most common cause of hemiparetic cerebral palsy and causes other significant morbidity including cognitive deficits, learning disabilities, motor problems, sensory problems including visual and hearing disorders, epilepsy, and behavioral and psychological problems. Family members are also affected because of the potential anxiety and guilt feelings that having a child with a stroke presents, along with the care that may be needed over the child&#...
Source: PediatricEducation.org - May 1, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
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
What Causes Sudden Vision Loss?
Discussion
Vision loss, whether chronic or acute, is distressing at any time for patients and families. Prompt evaluation and treatment are important as maintenance of any acuity and light or movement is considered paramount. Most vision loss is due to chronic problems and aging issues but the differential diagnosis is broad. For any age, but especially children, uncorrected refractive errors can cause problems in not only in childhood but throughout someone’s lifetime.
Visual impairment for distance vision is considered mild if worse than 6/12 in meters = 20/40 in feet or 0.3 LogMAR and for moderate impairment is 6/...
Source: PediatricEducation.org - September 5, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What is Ondine ’ s Curse?
Discussion
Congenital central hypoventilation syndrome (CCHS) is an autosomal dominant with variable inheritance genetic disease caused by mutation in the Paired Like Homeobox B2 (PHOX2B) gene on chromosome 4. There are two other genes which may also cause CCHS. CCHS affects the chemoreceptor afferent ventilation pathways and is a neural crest migration problem of the autonomic nervous system. The incidence is unknown but a prevalence of 1 in 200,000 live births has been reported. Obviously it is a rarer phenomenon because of the general lethality of the syndrome.
Patients usually present at birth or soon afterwards, but o...
Source: PediatricEducation.org - August 15, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Polyuria, Polydipsia and Possible Diabetes Insipidus?
Discussion
The body is smart. It has mechanisms for maintaining balances within the body in a closely controlled manner but allows for a variety of states. This is very true for fluid balance in the body which is highly controlled between almost all of the major body organ systems. When fluid is low, the sensor sends signals for us to drink, and conserves fluid until we can. When the fluid is high, the kidneys excrete the excess and sends signals not to drink. Usually it works very well. While there are many pathological states that can cause polyuria and/or polydipsia, the most common reason is excessive fluid intake beca...
Source: PediatricEducation.org - March 7, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What are Some Risk Factors for Hypoxic-Ischemic Encephalopathy Outcomes?
Discussion
“Neonatal encephalopathy, manifesting as altered responsiveness, seizures, apnea and abnormal muscle tone and reflexes, resulting from hypoxic-ischemic injury is termed hypoxic-ischemic encephalopathy (HIE).” Neonatal encephalopathy can be associated with other problems including stroke, hemorrhage, infection, pre-term brain injury and hypoglycemia as some examples. Sometimes more than one of these entities occurs simultaneously such as hypoglycemia and HIE. HIE can result in long-term neurological problems including motor, behavioral, and cognitive problems that can become apparent even years later....
Source: PediatricEducation.org - December 13, 2021 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 Types of Memory Impairments are There in Children?
Discussion
Memory is an important part of what distinguishes higher order species from others. Memory also is part of one’s self-identity. Difficulties in short-term memory can make common, everyday tasks difficult for the person experiencing the problem particularly if it recently occurred and the person’s long-term memory is intact. Difficulties with long-term memory can also have problems when language, events or even one’s own identity are affected. For some people the memory loss is temporary but for others, memory impairments are permanent and must be accepted and accommodated as part of the overall...
Source: PediatricEducation.org - March 30, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Some Risk Factors for Cerebral Palsy?
Discussion
The term, cerebral palsy, or CP has gone through many iterations with the first description in 1861 by W.J. Little who described it as “The condition of spastic rigidity of the limbs of newborn children.” The most recent definition is from Rosenbaun et al. in 2007 which states it is “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cog...
Source: PediatricEducation.org - March 9, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Facial Nerve Palsy?
Discussion
Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - June 3, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
How are Malformations of the Cerebral Cortex Grouped?
Discussion
Cerebral cortex development is an extremely complex process overall. Our current understanding is incomplete and constantly changing as our understanding of genetics and the processes each gene controls emerges from scientific research.
Neural cells are produced in the subventicular zone of the pallial or dorsal germinal epithelium. They then differentiate and migrate radially or tangentially to the cerebral cortex and organize themselves to function.
Malformations of cortical development (MCD) is a heterogeneneous group of disorders that cause defective cortical development. These disorders are broadly catego...
Source: PediatricEducation.org - July 23, 2018 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
