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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 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

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

What Genetics are Associated with Multiple Sclerosis?
Discussion Multiple sclerosis (MS) is “a chronic degenerative, often episodic disease of the central nervous system marked by patchy destruction of the myelin that surrounds and insulates nerve fibers, usually appearing in young adulthood and manifested by one or more mild to severe neural and muscular impairments, as spastic weakness in one or more limbs, local sensory losses, bladder dysfunction, or visual disturbances.” It is a chronic disease and therefore symptoms must occur more than once. The first episode is called an acute demyelinating attack. Fifteen to forty-five percent of children with their first...
Source: PediatricEducation.org - April 4, 2016 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What Are Common Inherited Thrombophilias?
Discussion Thrombophilia is the increased risk of thromboembolic disease due to a disorder. Thrombophilia can be inherited or acquired (such as antiphospholipid syndrome). The risk of thromboembolic events is much lower in children than adults. At-risk patients should avoid: Dehydration Sitting for prolonged time periods during travel Obesity Smoking Estrogen containing oral contraceptives Common inherited thrombophilias include: Prothrombin (Factor II mutation) Second most common Genetics: 1-2% prevalence is variable depending on location and ethnic background. Cause: Abnormal point mutation of the prothrombin gene t...
Source: PediatricEducation.org - May 25, 2015 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What is the Remission Rate for Antithyroid Drug Treatment for Hyperthyroidism in Children?
Discussion The thyroid gland secrets two hormones – T4 which is a prohormone and T3 which is the biologically active hormone. Receptors for T3 are found in nearly all body tissues. T3 regulates metabolism and energy production. Organs most affected are the heart, liver and central nervous system as well as growth of the fetus and child. Hyperthyroidism is common with a prevalence rate of about 1-2% for women and 0.2% for men. The most common cause of thyrotoxicosis is Grave’s disease where autoantibodies to thyroid stimulating hormone (TSH) exist. These autoantibodies attach to thyroid tissue TSH receptors and...
Source: PediatricEducation.org - January 26, 2015 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What Are the Essential Amino Acids and How Much Protein Do I Need?
Discussion Vegetarians have a diet pattern that emphasizes consuming plant foods (i.e. vegetables, grains and nuts) and avoiding flesh food (i.e. red meat, poultry, fish). Some vegetarians include milk and egg products in their diets and would be more accurately described as lacto-ova-vegetarians. Vegans are vegetarians who avoid all animal products including foods such as dairy products, eggs, butter, honey and gelatin. One of the most common questions that vegetarian are asked is about how they obtain enough protein from their diets. In general, a mixed diet of a variety of foods with appropriate calories should provide...
Source: PediatricEducation.org - September 29, 2014 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

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

What Causes Ataxia?
Discussion Coordination and balance problems are caused by various problems affecting the central and peripheral nervous system. Normal development of a child or weakness of a child are commonly mistaken for true ataxia. Ataxia specifically refers to “…impairment of the coordination of movement without loss of muscle strength.” If it is purely due to abnormalities of the cerebellum then there should be no changes in mental status, sensation or weakness. Sometimes it is difficult to determine if there are abnormalities in other areas. For example, Guillian-Barre often presents with difficulty or clumsy wal...
Source: PediatricEducation.org - March 31, 2014 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What Causes Muscle Weakness?
Discussion Muscle tone is the slight tension that is felt in a muscle when it is voluntarily relaxed. It can be assessed by asking the patient to relax and then taking the muscles through a range of motion such as moving the wrists, forearm and upper arm. Muscle strength is the muscle’s force against active resistance. Impaired strength is called weakness or paresis. There are 5 levels of muscle strength. 0 = No muscle contraction detected 1 = Barely detected flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity 4 = Active movement against gravity and some resistance ...
Source: PediatricEducation.org - December 9, 2013 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news