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Pediatric Annals

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https://www.readbyqxmd.com/read/27841924/pectus-excavatum-more-than-a-matter-of-aesthetics
#1
Fizan Abdullah, Jamie Harris
Pectus excavatum (PE) is the most common congenital chest abnormality, and affects males 5 times more frequently than females. PE results from improper fusion of the ribs with the sternum during embryologic development. The cardinal presenting sign is chest depression. Evaluation includes serial measurement of the chest deformity defect. Additional evaluation of cardiopulmonary function, including arrhythmias and pulmonary function tests, should be done as well. Computed tomography scans are used to determine the Haller index, a measure of deformity severity, with a measurement of greater than 3...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841923/urticaria-you-re-probably-just-allergic-to-something
#2
Jordan Smallwood
Urticaria is a common symptom seen in pediatric patients, and it has multiple allergic and nonallergic causes. Unfortunately, it is far too common that when children present acutely for urticaria, they are told that it is an "allergy." This statement often leads to increased anxiety while the patient waits to be evaluated by an allergist/immunologist. This article discusses the frequency that allergic reactions are involved in urticaria and provides examples of potential nonallergic causes. Additionally, the article discusses approaches to treatment that may be appropriate to initiate in the pediatrician's office or acute setting...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841922/emergency-department-triage-of-the-incessantly-crying-baby
#3
Caroline Chua, Jennifer Setlik, Victoria Niklas
Incessant crying is one of the most common caregiver complaints during emergency department (ED) visits in the first few months of the child's life. Although the majority of cases are attributed to normal infant behavior, the differential diagnosis remains broad. Moreover, the potential for the negative impact of incessant crying on the mental well-being of caregivers as well as the infants necessitates that complaints be taken seriously and that "red flags" for underlying organic causes be ruled out and caregiver anxiety quelled...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841921/difficulties-in-the-diagnosis-and-management-of-functional-or-recurrent-abdominal-pain-in-children
#4
Roberto Gomez-Suarez
Recurrent abdominal pain is a frequent pathology seen in the pediatric gastroenterology practice. In fact, most children with abdominal pain symptoms have functional disorders of the gastrointestinal tract. A focused medical history, comprehensive physical examination, and minimal testing are often enough to establish the diagnosis. The presence of red flags such as rectal bleeding, bilious vomiting, fever, and arthralgia should alert providers as well as direct further diagnostic and therapeutic plans. When patients show no red flags after a complete physical examination, providing the family with information about the pathophysiology and explaining the psychosocial model of pain can help to decrease anxiety around the pain symptoms...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841920/badly-behaving-noses-in-children-rhinitis-sinusitis-or-neither
#5
Jordan Smallwood, Julie L Wei
Every pediatrician has likely experienced frustration with cases of chronic nasal symptoms that either do not seem to get better or do show improvement but then worsen again. Often, this leads to the diagnosis of allergic rhinitis or sinusitis and subsequent prescription of medication(s) that may or may not be warranted. This article discusses the various causes of rhinitis, both allergic and nonallergic. Recommendations for treatment place special focus on nasal irrigation and the role that a child's diet can have on chronic nasal symptoms, with the hope of reducing excessive and sometimes unnecessary medication use...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841919/common-and-frustrating-patient-management-problems
#6
EDITORIAL
Kenneth Alexander
No abstract text is available yet for this article.
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841918/oral-health-basics-what-every-pediatrician-should-know
#7
Sabrina Fernandez
As soon as teeth are present, dental care should be discussed at every pediatric well-child visit. Many parents do not ask their pediatricians about dental care, assuming that it is the dentists' domain, but some families do ask lots of questions. Either way, pediatricians should discuss dental care at well visits, answering any questions and offering anticipatory guidance, especially on how to prevent caries. There are many questions from parents about dental care: how to brush, what kind of toothpaste to use, how to stop their child from grinding his or her teeth, whether or not pacifiers are bad for tooth development, and other inquiries that are addressed in the article...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841917/common-sense-approach-to-some-frustrating-everyday-clinical-problems-and-a-note-about-pacifier-use
#8
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735974/a-mindfulness-intervention-for-residents-relevance-for-pediatricians
#9
Mallory Taylor, Joseph R Hageman, Melanie Brown
Physician burnout is a topic of growing importance in today's health care system. Tangible interventions aimed at reducing burnout and promoting wellness are now necessary components of medical training and practice. A study examined the feasibility and impact of a brief mindfulness intervention using a free smartphone application with a resident population. Participants used a free smartphone application to complete a 10-day program in mindfulness meditation, and completed surveys at the end of the program...
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735973/skills-versus-pills-psychosocial-treatments-for-adhd-in-childhood-and-adolescence
#10
Erin N Schoenfelder, Tyler Sasser
Although side effects and family concerns are common and long-term medication adherence is low, stimulant medications are a front-line treatment for attention-deficit/hyperactivity disorder (ADHD). Psychosocial treatments include classroom, family, and child-focused interventions that teach caregivers and teachers how to implement contingencies to shape behavior and provide children with skills to compensate for ADHD deficits. Such programs have a growing evidence-base and can be implemented alone or in conjunction with pharmacological treatments...
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735972/pediatric-bipolar-disorder
#11
Terry Lee
The diagnosis of bipolar disorder (BD) in youth is confusing and controversial. Controversy notwithstanding, youth diagnosed with BD have high behavioral health needs and are at elevated risk for problematic long-term psychosocial functioning and complex psychiatric medication regimens. Pediatricians and other primary care providers (PCPs) can play an important role in the assessment and treatment of youth diagnosed with BD and the recently created and also controversial diagnosis of disruptive mood dysregulation disorder (DMDD)...
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735971/functional-neurological-symptom-disorder-in-youth
#12
Ian Kodish
Functional neurological symptom disorder (FNSD) is characterized by motor or sensory impairments inconsistent with recognized neurologic conditions. Usually emerging in adolescence, somatic symptoms remain challenging for the physician to assess and treat. Also termed "conversion disorder," FNSD has been recently reconceptualized with greater diagnostic emphasis on positive neurologic findings while eliminating the requirement for a precipitating stressor. This has broadened the initial treatment emphasis from mandating psychotherapeutic engagement to a more collaborative model that requires open communication of neurologic findings and strives to align with families' perspectives...
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735970/identification-and-treatment-of-generalized-anxiety-disorder-in-children-in-primary-care
#13
Erin Dillon-Naftolin
Youth with anxiety often present to their pediatricians with a chief complaint of physical symptoms without any mention of anxiety or worry. Even in the absence of reported symptoms of anxiety in such presentations, screening for an anxiety disorder as the potential source of the somatic complaints should be pursued. Generalized anxiety disorder (GAD) is a common disorder characterized by excessive anxiety and worry about a number of events coupled with at least one physical symptom. GAD is commonly underdiagnosed and treated...
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735969/mental-health-issues-in-foster-care
#14
W David Lohr, V Faye Jones
Children in foster care have exceptional needs due to their histories of abuse, neglect, and increased exposure to violence. The rates of psychiatric symptoms and disorders, such as attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and reactive attachment disorder, are much higher in children in foster care; furthermore, the rate of these children receiving psychotropic medications is 3 times that of children who are not in foster care. Pediatricians, in their role of providing a medical home, play a central role in safeguarding the physical and mental health of these children...
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735968/pediatric-mental-health-concerns
#15
William P French
No abstract text is available yet for this article.
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735967/social-emotional-development-quirky-or-time-to-worry
#16
Valerie Kimball
Primary care pediatricians spend a significant amount of time discussing and answering questions from parents regarding the behavior of their children. Although a majority of young children present with developmentally appropriate behavior, it is important that primary care pediatricians recognize concerning conduct that may be suggestive of a behavior or emotional disorder. It is important that social-emotional development is closely monitored in conjunction with physical and cognitive growth and development at each well visit...
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27735966/a-practical-and-holistic-approach-to-pediatric-mental-health
#17
Joseph R Hageman
No abstract text is available yet for this article.
October 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27622918/endometriosis-in-adolescence-practical-rules-for-an-earlier-diagnosis
#18
Letizia Zannoni, Simona Del Forno, Roberto Paradisi, Renato Seracchioli
Dysmenorrhea, cyclic pelvic pain, and acyclic pelvic pain are common in adolescent girls, and at least 10% of these girls are at risk for subsequent development of endometriosis. In this article we highlight practical tips for the management of dysmenorrhea and chronic pelvic pain and how to diagnose endometriosis as early as possible and detect patients at risk for developing the disease in the future. We suggest five practical rules for managing adolescents with dysmenorrhea and chronic pelvic pain: (1) Never underestimate the pain; (2) Always consider endometriosis as a possible cause of severe cyclic pain; (3) Obtain a detailed and accurate history before performing clinical evaluation and pelvic sonography; (4) Treat the pain with hormonal therapies (combined oral contraceptives or progestogen-only pill) and analgesics (acetaminophen and nonsteroidal anti-inflammatory drugs); and (5) Plan frequent follow-up visits to re-evaluate the patient...
September 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27622917/diabetes-control-and-adherence-in-adolescence
#19
Christy Foster, Jayne Bellando, Yu-Chi Annie Wang
Type 1 diabetes is a chronic disease that can lead to severe complications if poorly controlled. Adolescents are particularly vulnerable to worsening diabetes control due to changes in physiology, family dynamics, and social interactions. Good diabetes control requires following a regimen of frequent blood glucose checks, accurate carbohydrate counts, and compliance with insulin administration. Patients who are challenged in controlling their diabetes do tend to respond to behavioral interventions; however, the effect of the intervention wanes over time...
September 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27622916/cystic-fibrosis-related-diabetes-in-children-an-update
#20
Roy J Kim
Cystic fibrosis-related diabetes mellitus (CFRD) is the most common endocrine complication of cystic fibrosis (CF), affecting more than 50% of patients by the 4th decade of life. CFRD is often preceded by worsening pulmonary status and nutritional decline. Treatment of CFRD is associated with improvements in body weight and pulmonary function and a reduction in pulmonary exacerbations. Because of the clinical significance of CFRD, diabetes screening with an oral glucose tolerance test (OGTT) is recommended annually for all patients with CF starting at age 10 years...
September 1, 2016: Pediatric Annals
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