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Current Problems in Pediatric and Adolescent Health Care

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https://www.readbyqxmd.com/read/30017603/evaluation-and-management-of-concussion-in-young-athletes
#1
Jennifer Kosoy, Ronald Feinstein
Learning about concussion diagnosis and management is important for all individuals who will be taking care of young athletes. There are about 1.7million reported concussions per year, and, of these, about 20% are sports related. There are risks in all sports, but the highest rates of concussions are from football, rugby, and hockey, with soccer being the highest cause for girls. An on-field assessment includes evaluating airway, breathing, and circulation, followed by cervical spine assessment. Then, concussion evaluation tools can be used to aid in making the diagnosis...
July 14, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30017602/foreword-clearance-for-sports-participation-concussions-cardiovascular-and-other-medical-concerns
#2
Ronald Feinstein, Martin Fisher
No abstract text is available yet for this article.
July 14, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30017601/sports-participation-for-young-athletes-with-medical-conditions-seizure-disorder-infections-and-single-organs
#3
Camille Manuel Md, Ronald Feinstein Md
Organized and recreational sports have been shown to be an important part of growth and development in children, adolescents and young adults. In addition to the health benefits of increased physical activity, sports also provide social benefits. Pediatricians play an important role in determining if young athletes can participate in various sports and the proper equipment or precautions that are necessary. This review provides information on sports participation for athletes with specific health considerations, such as: febrile illnesses, solitary organs, seizures, and skin infections...
July 14, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29801771/subglottic-stenosis
#4
Katherine Hanlon, R Paul Boesch, Ian Jacobs
Subglottic stenosis refers to narrowing of the airway diameter below the vocal folds and may be congenital or acquired. Typical signs and symptoms range from recurrent croup and exertional stridor to complete airflow obstruction requiring tracheotomy. Management of moderate and severe subglottic stenosis often requires intricate surgical techniques. To optimize the success of these surgeries, a thorough assessment of the child's airway, lungs, reflux, and swallow needs to be evaluated. In order to provide concerted and coordinated care between typically otolaryngology (ENT), pulmonary, gastroenterology (GI), speech, swallow and language pathologists (SLP), "aerodigestive" teams have been developed and increasing in prevalence at children's medical hospitals...
April 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29657087/the-pediatric-aerodigestive-center-as-a-tertiary-care-based-medical-home-a-proposed-model
#5
Meghan M Galligan, Tara W Bamat, Annique K Hogan, Joseph Piccione
Children with special healthcare needs have been identified nationally as a population whose health care is associated with unmet needs; increased morbidity; fragmentation of care and medical errors; caregiver dissatisfaction; and disproportionately high costs. A subset of these children are medically fragile, with medical complexity that requires a reliance on tertiary care-based services-including subspecialty appointments, surgical procedures, and care coordination resources. For medically complex patients affected by upper and lower respiratory tract and gastrointestinal disorders, multidisciplinary aerodigestive centers have emerged at tertiary care centers across the United States to facilitate coordinated, high-quality, and high value care...
April 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29653906/vocal-fold-motion-impairment
#6
Karen B Zur
Vocal fold motion abnormalities in children are the second most common form of laryngeal pathology seen in children, and often present in the first 24 months of life. A thorough evaluation of the aerodigestive tract will include an examination of the vocal folds, and a proper diagnosis is essential in order to decipher the etiology of swallowing, voicing and breathing abnormalities. This article reviews the workup, management options and clinical outcomes of unilateral and bilateral vocal fold motion impairment in the pediatric population...
April 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29650455/foreword-aerodigestive-disorders-part-ii
#7
EDITORIAL
Louis M Bell
No abstract text is available yet for this article.
April 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29622320/laryngomalacia-tracheomalacia-and-bronchomalacia
#8
Erik B Hysinger
Airway malacia can occur in the larynx (larygomalacia), trachea (tracheomalacia), or bronchi (bronchomalacia). As a group these are the most common congenital abnormalities of the pediatric airway and are characterized by increased airway compliance, resulting in excessive dynamic collapse during the respiratory cycle. While a diagnosis can be suspected based on clinical history and physical examination, definitive evaluation is based of nasopharyngolaryngoscopy and/or bronchoscopy. Observation and conservative management are typically all that are required...
April 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29602647/bronchiectasis-chronic-suppurative-lung-disease-and-protracted-bacterial-bronchitis
#9
Dan T Benscoter
Bronchiectasis is a structural airway disease characterized by dilated bronchi and bronchioles due to severe or recurrent lower airways inflammation. Bronchiectasis can occur as a result of chronic pulmonary aspiration. Bronchiectasis may also be associated with a wide variety of systemic diseases, which should be considered in the differential diagnosis. Children with bronchiectasis typically have a chronic or recurrent productive cough and carry a significant burden of disease with a considerable impact on quality of life...
April 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29566989/the-role-of-the-medical-social-worker-in-a-pediatric-aero-digestive-program
#10
Amanda Fonash
Families experience many psycho-social challenges when caring for a child with a tracheostomy in the home. The support of a Medical Social Worker in a Pediatric Aero-digestive Program is vitally important to help families navigate the multiple systems required to help manage the needs of medically complex child. The Medical Social Worker should strive to partner with families to provide resources and coordinate care to enhance coping and improve overall patient care and well-being.
April 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29571547/eosinophilic-esophagitis
#11
Amanda B Muir
Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease of the esophagus that effects children and adults. Typical symptoms of EoE typically involve failure to thrive and vomiting in small children, and dysphagia and food impaction in adolescents and adults. However, throat clearing, choking, gagging, and hoarseness have also been observed and these issues often bring patients to first seek otolaryngology and pulmonary evaluation. Diagnosis is only made by esophogastroduodenoscopy with biopsy, so clinicians must have a low threshold for considering eosinophilic esophagitis even in the absence of frank gastrointestinal symptoms...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29571546/gastroesophageal-reflux-disease-and-aerodigestive-disorders
#12
Asim Maqbool, Matthew J Ryan
This relationship between gastroesophageal reflux and airway disorders is complex, possibly bidirectional, and not clearly defined. The tools used to investigate gastroesophageal reflux are mostly informative about involvement of gastroesophageal reflux within the gastrointestinal tract, although they are often utilized to study the relationship between gastroesophageal reflux and airway issues with are suspected to occur in relation to reflux. These modalities often lack specificity for reflux-related airway disorders...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29571545/diagnosis-and-management-of-laryngotracheoesophageal-cleft
#13
Steven E Sobol
Laryngotracheoesophageal cleft (LTEC) is a rare anatomic cause of aspiration in the newborn and infant. The clinical presentation of infants with LTEC is variable and will usually vary with the degree of anatomic communication between the airway and esophagus. The diagnosis of LTEC is often challenging, particularly in cases where the presentation and pathology are more subtle. Management of LTEC depends upon the clinical presentation, degree of aspiration, and anatomic depth of the cleft. The goal of this review is to present the clinician with a practical approach to diagnosis and management of this rare but challenging congenital airway anomaly...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29571544/chronic-pulmonary-aspiration-in-children-diagnosis-and-management
#14
Cherie A Torres-Silva
Chronic pulmonary aspiration (CPA) is a common cause of morbidity in children with complex aerodigestive disorders. CPA can be caused by swallowing dysfunction, anatomic, or dynamic abnormalities of the airways, and/or other circumstances that overcome the child's natural capacity to protect the airway. Diagnostic evaluation for suspected aspiration aims to characterize the swallowing function, identify the etiology of aspiration, including anatomic and/or dynamic abnormalities causing aspiration, and evaluate for the development of aspiration sequelae (e...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29571543/dysphagia-in-children
#15
Kimberly L Duffy
Speech-Language Pathologists (SLP) play an integral role in evaluating and treating pediatric patients with dysphagia related to aerodigestive disorders. Non-supportive anatomy, cardio-respiratory and medical status, state control, neurologic functioning, postural stability and control, gastrointestinal functioning, hunger and satiation, developmental abilities, oral-motor skills, oral/pharyngeal reflexes, airway protection and secretion management can create barriers to successful oral feeding. Swallowing is broken down into four phases and difficulties can occur during any phase or in combination with another phase of swallowing...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29571542/the-multidisciplinary-approach-to-pediatric-aerodigestive-disorders
#16
Joseph Piccione, R Paul Boesch
Multidisciplinary programs for the care of children with upper and lower respiratory and gastrointestinal tract disorders have emerged across the United States and become known as aerodigestive centers. This model is designed to improve clinical outcomes and healthcare value through a coordinated approach by a team that appreciates the inter-relatedness of these disorders. The primary elements include: (1) Interdisciplinary medical and surgical team, (2) Care coordination, (3) Team meeting, and (4) Combined endoscopic procedures...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29477602/foreword-aerodigestive-disorders-part-i
#17
EDITORIAL
Louis M Bell
No abstract text is available yet for this article.
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29477219/commentary-recent-advances-in-pediatric-psychopharmacology
#18
Andrew Smith
No abstract text is available yet for this article.
February 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29477218/foreword-update-on-the-treatment-of-depression-and-pharmacogenomics-testing-in-children-and-adolescents-dr-strawn-and-colleagues
#19
EDITORIAL
John M Pascoe
No abstract text is available yet for this article.
February 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29358037/antidepressant-induced-activation-in-children-and-adolescents-risk-recognition-and-management
#20
Marissa J Luft, Martine Lamy, Melissa P DelBello, Robert K McNamara, Jeffrey R Strawn
The tolerability of antidepressants is poorly characterized in children and adolescents with depressive and anxiety disorders. Among adverse events that affect the tolerability of antidepressants in youth is activation, a cluster of symptoms that represent a hyperarousal event characterized by impulsivity, restlessness, and/or insomnia. This cluster of symptoms was first identified as a side effect of selective serotonin and selective serotonin norepinephrine inhibitors (SSRIs and SSNRIs) in the early 1990s; however, activation remains poorly characterized in terms of prevalence, risk factors, and pathophysiology...
February 2018: Current Problems in Pediatric and Adolescent Health Care
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