health_issue_x_health_issue_article.id,health_issue.id,health_issue.ts,health_issue.title,health_issue_article.id,health_issue_article.ts,health_issue_article.title,health_issue_article.content
301,14,"2018-04-19 02:48:19","From Insects or Animals",301,"2018-04-19 03:29:52","Healthy Children Radio: Head Lice","Healthy Children Radio: Head Lice Page Content Article BodyEvery year, 6 to 12 million school-age children get head lice. Pediatrician Robert Murray, MD, FAAP, explains how lice spread, how to identify symptoms, and effective treatment options in an interview on the Healthy Children Radio Show. Segment 1: Lice are Back! Keep Your Child Free of the Little Buggers Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2013)"
302,14,"2018-04-19 02:48:19","From Insects or Animals",302,"2018-04-19 03:29:56",Hookworms,"Hookworms Page Content Article BodyHookworms are small (less than 0.5 inches long) parasitic worms that can cause infections in the small intestines. The major species of hookworms associated with infections in humans are Ancylostoma duodenale and Necator americanus. They get their name from the teeth (“hooks”) or cutting plates in their mouths by which they attach themselves to the intestinal wall. Hookworm diseases are most common in tropical and subtropical climates. These infections develop after a person has contact with soil contaminated with human feces. Children are at high risk because they often play barefoot in areas with contaminated soil. In soil, hookworm eggs hatch and form larvae, which then burrow through the skin of a person’s foot and crawl into the blood. The blood carries the larvae to the lungs, where they enter into the air sacs. The hookworms then crawl up the breathing tubes to the throat, where they are swallowed. The larvae pass through the stomach and mature into adult worms in the bowel. The worm holds onto the bowel wall with hooks, which cause minor bleeding. Adult hookworms live in the bowel and lay eggs that pass out of the child with the stool. Signs and Symptoms Most children with hookworm infections have no signs or symptoms. However, especially when the infection is long term, it can cause iron deficiency and anemia (low red blood cells) because of bleeding from the bowel wall where the worm is attached. Other symptoms include mild diarrhea and stomach cramps. An itchy, red skin rash (ground itch) can appear on the feet where the larvae entered the body. Lung inflammation with cough, wheezing, and fever rarely occur while the larvae migrate through the lungs. Several weeks after exposure to this hookworm, a loss of appetite and weight loss may occur. Chronic infections can lead to poor nutrition. How Is the Diagnosis Made? A stool sample from your child will be tested in the laboratory to look for evidence of hookworm eggs. Treatment Antiparasitic drugs are used to treat hookworm infections. The oral medicines commonly prescribed include a single dose of albendazole or 3 days of mebendazole or pyrantel. One to 2 weeks following treatment, your pediatrician may test another stool sample from your child. The drug therapy should be repeated if the infection persists. Iron supplements help replace the iron your child has lost. What Is the Prognosis? Proper treatment of hookworm infections results in a high recovery rate. How Is the Diagnosis Made? Reinfection is common. Wearing shoes prevents the larvae from entering the body through the feet. If your child goes barefoot, make sure she avoids contact with soil that may be contaminated with human feces. Last Updated 11/21/2015 Source Adapted from Immunizations and Infectious Diseases: An Informed Parents Guide (Copyright © 2006 American Academy of Pediatrics) and updated 2011"
303,14,"2018-04-19 02:48:19","From Insects or Animals",303,"2018-04-19 03:30:09","How To Remove A Tick","How To Remove A Tick Page Content Article BodyTreating Tick BitesReassuranceMost tick bites are harmless.The spread of disease by ticks is rare.If the tick is still attached to the skin, it will need to be removed.Covering the tick with petroleum jelly, nail polish, or rubbing alcohol doesn't work. Neither does touching the tick with a hot or cold object.Try one of the following techniques:Wood Tick Removal: Try Soapy Cotton Ball FirstApply liquid soap to a cotton ball until it's soaked.Cover the tick with the soap-soaked cotton ball.Let it stay on the tick for 30 seconds.The tick will usually be stuck to the cotton ball when you lift it away.Wood Tick Removal: Try Tweezers SecondUse tweezers and grasp the tick close to the skin (on its head).Pull the wood tick straight upward without twisting or crushing it.Maintain a steady pressure until it releases its grip.If tweezers aren't available, use fingers, a loop of thread around the jaws, or a needle between the jaws for traction.Deer Tick Removal Tiny deer ticks need to be scraped off with a fingernail or credit card edge.Tick's HeadIf the wood tick's head breaks off in the skin, remove it.Clean the skin with rubbing alcohol.Use a sterile needle to uncover the head and lift it out.If a small piece of the head remains, the skin will eventually shed it.If most of the head is left, call your doctor.Antibiotic Ointment Wash the wound and your hands with soap and water after removal to prevent catching any tick disease. Apply antibiotic ointment such as Polysporin to the bite once (no prescription needed).Expected CourseTick bites normally don't itch or hurt. That's why they often go unnoticed.Call Your Doctor IfYou can't remove the tick or the tick's head. Fever or rash in the next 2 weeks.Bite begins to look infected.Your child becomes worse.Preventing Tick BitesPreventionWhen hiking in tick-infested areas, wear long clothing and tuck the ends of pants into socks. Apply an insect repellent to shoes and socks.Permethrin products applied to clothing are more effective than DEET products against ticks.Tick Repellent for Skin: DEETDEET is an effective tick repellent.Use 30% DEET for children and adolescents (American Academy of Pediatrics recommendation, 2003) (30% DEET protects for 6 hours).Tick Repellent for Clothing: PermethrinPermethrin-containing products (eg, Duranon, Permanone) are highly effective tick repellents.An advantage over using DEET is that they are applied to and left on clothing instead of skin. Apply it to clothes, especially pants, cuffs, socks, and shoes. You can also put it on other outdoor items (eg, mosquito screen, sleeping bags).Do not apply permethrin to skin (Reason: it's rapidly degraded on contact with skin).And remember, contact your doctor if your child develops any of the ""Call Your Doctor"" symptoms. Last Updated 11/21/2015 Source My Child Is Sick! Expert Advice for Managing Common Illnesses and Injuries (Copyright © 2011 Barton D. Schmitt, MD, FAAP)"
304,14,"2018-04-19 02:48:19","From Insects or Animals",304,"2018-04-19 03:30:14","How to Help Prevent and Control the Spread of Head Lice","How to Help Prevent and Control the Spread of Head Lice Page Content Article BodyHead lice are spread most commonly by direct head-to-head (hair-to-hair) contact. However, much less frequently they are spread by sharing clothing or belongings onto which lice have crawled or nits attached to shed hairs may have fallen. The risk of getting infested by a louse that has fallen onto a carpet or furniture is very small. Head lice survive less than 1–2 days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if they are not kept at the same temperature as that found close to the scalp.Take the Following Steps To Prevent and Control the Spread of Head Lice: 1.       Avoid head-to-head (hair-to-hair) contact.Kids will be kids, but tell them to avoid head-to-head contact while playing with other children, whether at school, on a playground, or during sports activities. Since head lice also can't fly, hop, or jump, they'll pass on to your children only through direct contact.2.       Say ""no"" to sleepovers until 48 hours after treatment and no living lice visualizedIf there's a head lice outbreak in your child's school, put sleepover parties on hold for a while, since head lice can live in bedding, pillows, and carpets that have recently been used by someone with head lice.3.       Don't share what's on your hair.Tell kids not to share combs, brushes, hats, scarves, bandanas, hair bands, ribbons, barrettes, or towels — basically, anything that goes on kids' heads. Disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5–10 minutes .4.       Think wisely when it comes to your house.Extreme environmental clean-up does not appear to lessen the spread of lice. However, washing pillow cases may be useful. Spending excessive time and money on housecleaning activities is not necessary to avoid re-infestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.Common sense should guide you if you wish to do anything more. You may avoid lying on beds, couches, pillows, carpets, or stuffed animals that have been in immediate contact with an untreated, infested person.You may choose to machine wash and dry clothing, bed linens, and other items that an untreated, infested person wore or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned OR sealed in a plastic bag and stored for 2 weeks.You may vacuum the floor and furniture, particularly where the untreated, infested person sat or lay. 5.       Be sure other members of the household including dual households and yourself are examined and treated for head lice if needed.6.       Do not use pest sprays and fogs in the house. They are not necessary to control head lice and can be harmful if they are inhaled or get into the skin, especially on young children. Additional Information: Head Lice: What Parents Need to KnowHead Lice (AAP Clinical Report)National Association of School Nurses Last Updated 9/11/2015 Source Adapted from Head Lice Prevention ＆ Control (Copyright © 2013 Centers for Disease Control and Prevention)"
305,14,"2018-04-19 02:48:19","From Insects or Animals",305,"2018-04-19 03:30:24","How to Protect Your Child from Insect Stings","How to Protect Your Child from Insect Stings Page Content​​Children are naturally curious and want to explore. As a result, they can come in contact with bees, wasps, yellow jackets, hornets, and fire ants.Tips Keep Your Child Safe From Insect Stings:Check for nests in areas where children play. Nests can be found in old tree stumps, around rotting wood, and in holes in the ground. Check in auto tires that are part of a playground. Look around trash cans.Have insect nests removed by a professional exterminator.Don’t allow children who are allergic to insects to play outside alone when stinging insects are active. Even a dead insect can sting if a child steps on it or picks it up. Wear shoes. Avoid wearing sandals or going barefoot. Avoid wearing bright colors and floral patterns. These can attract insects. Wear white, green, tan, and khaki. These colors are not as attractive to insects. When eating outdoors, avoid foods that attract insects. Some examples are tuna, peanut butter and jelly sandwiches, and watermelon. Sweetened drinks, frozen sweet treats, and ice cream also attract insects. Stay away from garbage cans and dumpsters. If an insect is near, do not swat at it or run. These actions can trigger an attack. Walk away slowly. If you have disturbed a nest and the insects swarm around you, curl up as tightly as you can to reduce exposed skin. Keep your face down and cover your head with your arms. A child who is allergic to insects should wear a medical alert necklace or bracelet.Additional Information from HealthyChildren.org: Summer Safety Tips: Staying Safe Outdoors How to Build an Essential Summer First Aid KitUnderstanding Childhood Fears and AnxietiesSafety on the PlaygroundAnaphylaxis ​ Article Body Last Updated 4/24/2013 Source First Aid for Families (PedFACTs) (Copyright © 2012 American Academy of Pediatrics)"
306,14,"2018-04-19 02:48:19","From Insects or Animals",306,"2018-04-19 03:30:27","Identifying Insect Bites and Stings","Identifying Insect Bites and Stings Page Content Article BodyMosquitoesMosquitoes are generally found near water (pools, lakes, birdbaths) and are attracted by bright colors and sweat. Bites result in stinging sensation followed by a small, red, itchy mound with a tiny puncture mark at the center.FliesUsually found near or around food, garbage, and animal waste. Painful, itchy bumps that may turn into small blisters are characteristic of bites. These bites often disappear in a day but may last longer.FleasFlea bites are usually identified by the presence of multiple small bumps clustered together, –often where clothes fit tightly (waist, buttocks). Fleas are commonly found in floors, rugs, and are mostly likely to be problematic in homes with pets.BedbugsBedbugs are usually found in cracks in walls or floors, crevices of furniture and bedding. Bedbug bites are characterized by itchy red bumps (which are occasionally topped by a blister) usually 2–3 in a row. Bites are more likely to occur at night. Bedbugs are less active in cold weather.Fire AntsImmediate pain and burning sensation is frequently experienced after a bite followed by swelling (up to ½ inch) and cloudy fluid in area of bite. Fire ants usually attack intruders and are commonly found in pastures, meadows, lawns and parks in southern states.Bees and WaspsThese winged insects are usually found near flowers, shrubs, picnic areas, or beaches. Immediate pain and rapid swelling occur following a sting. A few children have severe reactions, –such as difficulty breathing and hives/swelling all over their body.TicksTicks are found in wooded areas. They may be unnoticeably hidden on hair or on skin. When attempting to remove a tick do not use matches, lit cigarettes, or nail polish remover. Grasp the tick near the head with tweezers, and gently pull the tick straight out. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
307,14,"2018-04-19 02:48:19","From Insects or Animals",307,"2018-04-19 03:30:33","Illness from Animals: Leptospirosis","Illness from Animals: Leptospirosis Page Content Article BodyLeptospirosis is a bacterial infection caused by species of Leptospira organisms that can infect domestic and wild animals. The bacteria is excreted in the animal’s urine and can survive in the soil or water for weeks or months. Humans can then become infected from the contaminated soil or water, often during activities like swimming or canoeing in lakes or rivers. The bacteria enter the body through cuts in the skin; through the nose, eyes, or mouth (mucosal membranes); or by swallowing contaminated water. It is very rare for the infection to spread from person to person. The time from exposure to the bacteria until beginning of illness is about a week, but sometimes can take as long as a month. Leptospirosis is an uncommon disease. The Centers for Disease Control and Prevention estimates that about 100 to 200 cases are identified each year in the United States, with about half of those cases occurring in Hawaii. It is more common in other parts of the world. Signs and Symptoms Illness seen with leptospirosis includes: Fever and chills Headaches Muscle soreness in the calves and back Redness of the eyes (conjunctivitis) Abdominal pain, nausea, and vomiting Skin rash over the shins (pretibial) These symptoms may initially last for 3 to 7 days. Then there may be a short period (for 1 to 3 days) during which the fever goes away, followed by a second phase in which the fever returns, with any of the previously described symptoms as well as increased inflammation of the eye (uveitis, iritis), covering of the brain (meningitis), liver (hepatitis), and lymph nodes. The rash may become worse. At times, leptospirosis can be life threatening (Weil syndrome).When the infection goes untreated, liver infection (hepatitis) with yellowing of the skin and eyes (jaundice), bleeding, kidney failure, irregular heart rhythms, inflammation of the lining of the brain and spinal cord (meningitis), and a form of pneumonia called hemorrhagic pneumonitis may develop. When to Call Your Pediatrician Contact your pediatrician if your child has symptoms that suggest the presence of leptospirosis. How Is the Diagnosis Made? Most often, leptospirosis is diagnosed with antibody testing of blood samples.  Treatment Your pediatrician will prescribe antibiotics to treat leptospirosis. Children with a mild infection can be treated with oral amoxicillin if they are younger than 8 years. Oral doxycycline is used for children 8 years and older. (In young children, tetracyclines such as doxycycline can cause staining of the teeth.) Some patients with leptospirosis become very ill and should be hospitalized to receive penicillin intravenously. What Is the Prognosis?  This disease can last from a few days to several weeks, but most children fully recover. Even so, some of the serious complications such as brain or spinal cord inflammation or kidney damage can cause lasting health problems. On rare occasions, death may occur.  Prevention Make sure your child follows good hygiene habits. She should wash her hands frequently and avoid direct contact with the urine of pets and other animals. Your child should not play in and around dirty puddles of standing water in the outdoors. Although there is a vaccine to protect pets from leptospirosis, there is no vaccine approved for use in people. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
308,14,"2018-04-19 02:48:19","From Insects or Animals",308,"2018-04-19 03:30:39","Lyme Disease","Lyme Disease Page Content Article BodyLyme disease is an important public health problem in some areas of the United States. Since its discovery in Lyme, CT, in 1975, thousands of cases of the disease have been reported across the United States and around the world. By knowing more about the disease and how to prevent it, you can help keep your family safe from the effects of Lyme disease. What is Lyme disease? Lyme disease is an infection caused by a bacteria called a spirochete. The disease is spread to humans by the bites of deer ticks infected with this bacteria. Deer ticks are tiny black-brown creatures. They live in forests or grassy, wooded, marshy areas near rivers, lakes, or oceans. Many people who have been infected with Lyme disease were bitten by deer ticks while hiking or camping, during other outdoor activities, or even while spending time in their own backyards, from the late spring to early fall. Where is Lyme disease most common? Deer ticks that are infected with Lyme disease live in areas that have very low and high seasonal temperatures and high humidity. In the United States, almost all cases of Lyme disease occur in the following regions: Northeast (Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont) North central states (Michigan, Minnesota, and Wisconsin) West Coast(California)   How will I know if my child has Lyme disease? The first and most obvious symptom of Lyme disease is a localized rash that begins as a pink or red circle that expands over time and may become several inches or larger. It may appear from 3 to 30 days after the bite occurred. Some people may have a single circle, while others may have many. Most people who develop the rash won't feel anything, but for others the rash may hurt, itch, burn, or feel warm to the touch. The rash most commonly appears on the head, neck, groin, thighs, trunk, and armpits. A rash may occur without any other symptoms or may include Headache Chills Fever Fatigue Swollen glands, usually in the neck or groin Aches and pains in the muscles or joints   If your child develops the rash with or without any of these symptoms, call your pediatrician. How serious is Lyme disease? For most people, Lyme disease can be easily recognized and treated. If left untreated, Lyme disease can get worse. Occasionally, patients can develop infection of the nervous system (meningitis) or facial muscle problems (facial nerve palsy). Late stage symptoms, occurring 1 or more months after the tick bite, are swelling of one or more joints. How is Lyme disease treated? Lyme disease is treated with antibiotics (usually penicillin, a cephalosporin, or a tetracycline) prescribed by your pediatrician. The antibiotics are usually taken by mouth, but also can be given intravenously (directly into the bloodstream through a vein) in more severe cases. Both early and late stages of the disease can be treated with antibiotics. How can I prevent Lyme disease? If you live or work in a region where Lyme disease is a problem, or if you visit such an area, the following are ways to protect your family from the ticks that carry the disease: Avoid places where ticks live. Whenever possible, avoid shaded, moist areas likely to be infested with ticks. Cover arms and legs. Have your child wear a long-sleeved shirt and tuck his pants into his socks. Wear a hat to help keep ticks away from the scalp. Keep long hair pulled back. Wear light-colored clothing to make it easier to spot ticks. Wear enclosed shoes or boots. Avoid wearing sandals in an area where ticks may live. Use insect repellent. Products with DEET are effective against ticks and can be used on the skin. However, large amounts of DEET can be harmful to your child if it is absorbed through the skin. Look for products that contain no more than 30% DEET. Wash the DEET off with soap and water when your child returns indoors. Products with permethrin can be used on clothing, but cannot be applied to the skin. Stay on cleared trails whenever possible. Avoid wandering from a trail or brushing against overhanging branches or shrubs. After coming indoors, check for ticks. This will only take a couple minutes. Ticks often hide behind the ears or along the hairline. It usually takes more than 48 hours for a person to become infected with the bacteria, so removing any ticks soon after they have attached themselves is very effective for reducing the chances of becoming infected.   Keep in mind, ticks can be found right in your own backyard, depending on where you live. Keeping your yard clear of leaves, brush, and tall grass may reduce the number of ticks. Ask a licensed professional pest control expert about other steps you can take to reduce ticks in your yard. Ticks and how to remove them Ticks do not fly, jump, or drop from trees. They hide in long grass and small trees, bushes, or shrubs waiting for an animal or person to brush by. Then they attach themselves to the animal or person's skin. When a tick is found on a person or pet, try to remove as much of it as possible using the following steps: Grasp the tick as close to the skin as possible with fine-tipped tweezers. Be careful not to squeeze the tick's body. Slowly pull the tick away from the skin. After the tick is out, clean the bitten area with rubbing alcohol or other first aid ointment. Remember If you live in or plan to visit an area where Lyme disease has become a problem, it's important to take steps to avoid being bitten by deer ticks. If you have any questions about the disease, talk with your pediatrician. Last Updated 11/21/2015 Source Lyme Disease (Copyright © 2004 American Academy of Pediatrics, Updated 8/2012)"
309,14,"2018-04-19 02:48:19","From Insects or Animals",309,"2018-04-19 03:30:45","Marine Animal Stings","Marine Animal Stings Page Content Article BodyStings from marine animals can cause injury. Reactions range from mild inflammation to a severe reaction. Some types of stings can be deadly. Most stings occur in shallow ocean water. Some marine animals that sting are jellyfish and Portuguese man-of-war. These animals sting by firing special tentacles called nematocysts. Nematocysts contain poison. Stinging is how these animals capture their prey and defend themselves against attack. It is important to identify the offending animal because in many cases care is quite specific. What Parents Should Look ForA raised bump or ridge (welt) with rednessBurning painMuscle crampingFirst Aid Care for Marine Animal StingsRemove the child from the water.Rinse the skin with sea water.Pour vinegar on the affected area until pain is relieved. Unlike fresh water, vinegar will make the nematocysts inactive.Try to remove the loose tentacles by scraping them off with the edge of a sharp, stiff object such as a credit card. Do not handle tentacles with bare hands. Last Updated 11/21/2015 Source Pediatric First Aid For Caregivers And Teachers (PedFACTs), 2nd Edition (Copyright © 2013 Jones ＆ Bartlett Learning, LLC, an Ascend Learning Company, and the American Academy of Pediatrics)"
310,14,"2018-04-19 02:48:19","From Insects or Animals",310,"2018-04-19 03:30:52","Pet Birds and Psittacosis Infection","Pet Birds and Psittacosis Infection Page Content Article BodyYou may not be familiar with a disease called psittacosis. If you have pet birds such as parrot-like birds, you should know something about it. Psittacosis, or ornithosis, is a respiratory tract infection caused by the Chlamydia (or Chlamydophila) psittaci organism. The sources of psittacosis include parakeets, parrots, macaws, and cockatiels, especially those that may have been smuggled into the country. Pigeons and turkeys are other sources of the disease. In most cases, this disease is spread to humans when they breathe in airborne dust particles from dried bird feces. Birds do not have to be sick to transmit the disease. Transmission from person to person is very uncommon. Fortunately, this infection occurs rarely in children. The incubation period is a week or two but may be longer. Signs and Symptoms Children with psittacosis have mild flu-like symptoms that often include: Fever A nonproductive cough Headaches A general sense of not feeling well and tiredness Some patients develop pneumonia. On rare occasions, complications such as inflammation of the heart (myocarditis), lining of the heart (pericarditis), liver (hepatitis), and brain (encephalopathy) may occur. When To Call Your Pediatrician If your child has symptoms associated with psittacosis that don’t improve over several days and has been around pet birds, call your pediatrician. How Is the Diagnosis Made? Psittacosis is usually diagnosed by taking a medical history of the child, inquiring about exposure to birds, and evaluating the youngster’s symptoms. The diagnosis can be confirmed by blood tests that detect increases of antibodies to the bacteria. Treatment Children with psittacosis are usually treated with azithromycin if they are younger than 8 years, and doxycycline if they are older. What Is the Prognosis? With proper treatment, the overwhelming majority of children recover fully from the infection. Prevention If you have birds as pets, clean their cages frequently so their feces do not build up and become airborne. Only purchase birds from a trustworthy breeder or importer. Birds that are believed to be the source of a human infection need to be evaluated and treated by a veterinarian and may need antibiotics. Cages, food bowls, and water bowls that may be contaminated should be disinfected thoroughly, using a household disinfectant such as a 1:100 dilution of bleach or detergent, before they are used again. Last Updated 11/21/2015 Source Adapted from Immunizations and Infectious Diseases: An Informed Parents Guide (Copyright © 2006 American Academy of Pediatrics) and updated 2011"
311,14,"2018-04-19 02:48:19","From Insects or Animals",311,"2018-04-19 03:30:55","Pets and Pasteurella Infections","Pets and Pasteurella Infections Page Content Article BodyBacterial organisms from the Pasteurella species live in the mouths of most cats, as well as a significant number of dogs and other animals. If your child is bitten or scratched by an animal that carries Pasteurella organisms such as Pasteurella multocida, these bacteria can enter the body through the break in the skin. They most often cause a potentially serious infection of the skin called cellulitis. On occasion, these bacteria can be spread to humans from an animal’s saliva or nose mucus. Signs and Symptoms Symptoms of cellulitis usually begin after a very short incubation period, typically within 24 hours after your child has been bitten or scratched. He may develop swelling, redness, warmth, and tenderness of the skin, sometimes with discharge of pus. In some children, lymph nodes in the area of the infected skin may become enlarged and chills and fever can occur. Complications may be present in some children, including an infection of the joints (arthritis), bones (osteomyelitis), and tendons (tenosynovitis). Less frequently, youngsters may have pneumonia, urinary tract infections, meningitis, blood infections (septicemia), or eye infections. What You Can Do If your child is bitten or scratched by an animal, wash the wound thoroughly with soap and water. When To Call Your Pediatrician If your child is bitten or scratched by a pet, wild animal, or any animal unknown to you, call your pediatrician for advice after promptly washing the wound. Also contact your doctor if you notice that an area of your child’s skin has become red, warm, and tender. How Is the Diagnosis Made? Your pediatrician will examine the area of your child’s skin that has been bitten or scratched. The doctor can order tests such as cultures and smears of the drainage from the wound to help identify the infectious organism. Treatment Your pediatrician will prescribe antibacterial treatment as soon as cellulitis is found. In most cases, children are treated with oral amoxicillin clavulanate because the exact cause of the cellulitis may not be known. If a culture shows the infection is caused by Pasteurella, oral penicillin can be used. Most infections require a 7- to 10-day dose of antibacterials, occasionally longer. Your pediatrician also may drain and clean the wound. If your child is very ill, the infection involves the hands, or it is spreading rapidly, your pediatrician will suggest hospital admission and use of intravenous antibacterials. Intravenous antibacterials are used for infections involving the blood, bone, joints, and brain. Following an animal bite, especially one involving the hands, your doctor may prescribe a preventive antibacterial medicine to stop an infection from occurring. The pediatrician will make sure that your child has been protected with tetanus vaccine and the doctor will decide if there is any risk for rabies. What Is the Prognosis? When appropriately treated with antibacterials, Pasteurella-related cellulitis usually clears up in about a week. Make sure your child takes the complete course of antibacterials, even if symptoms go away before all the pills are gone. Prevention Pets should not be allowed to lick very young infants. Teach your child not to approach or touch unfamiliar pets or wild animals and never disturb an animal that is eating. Last Updated 11/21/2015 Source Adapted from Immunizations and Infectious Diseases: An Informed Parents Guide (Copyright © 2006 American Academy of Pediatrics) and updated 2011"
312,14,"2018-04-19 02:48:19","From Insects or Animals",312,"2018-04-19 03:31:01",Rabies,"Rabies Page Content Article Body  Children are the victims of about 60% of all dog bites in the United States. Fortunately, a relatively small number of these bites spread the very serious rabies infection. Rabies has become a very rare disease, averaging no more than 5 cases a year in the United States and 1 to 2 deaths annually. Rabies is caused by a virus that is present in an infected animal and spread to humans via bites or scratches. The greatest risk comes from wild animals, especially bats, but also raccoons, skunks, foxes, and coyotes. Domestic pets such as dogs and cats are usually immunized against rabies. The incubation period averages 4 to 6 weeks, although it can be shorter with bites on the face or much longer in some cases of bites on the feet or legs (extending more than a year on occasion). Signs and Symptoms When the rabies virus enters the body, it can move along the nerve pathways to the brain. It causes serious symptoms beginning with pain, tingling, and numbness at the site of the bite or scratch and progresses rapidly to: Anxiety, restlessness, and aggressiveness Swallowing difficulties, particularly water (hydrophobia) Muscle spasms Drooling Seizures Paralysis Coma and death What You Can Do If your child has been bitten by an animal, thoroughly flush the wound with water and wash it with soap and water. If possible, it is important that the animal be captured so it can be evaluated by a veterinarian for the presence of a rabies infection. Unless proper equipment is available, however, capturing a possibly rabid animal should not be attempted. Captured animals are killed and their brains are examined for rabies immediately. Pets who appear well and have been immunized can be watched for symptoms of the disease. This observation period should extend for 10 days. If the animal develops symptoms, it must be killed and the brain examined. When to Call Your Pediatrician Any time that your child is bitten by an animal, contact your pediatrician. All animal bites should be reported to health officials who will be able to tell you whether the bite presents a risk of rabies. Any bite by a wild animal should be considered a risk for rabies until proven otherwise. Exceptions to this include rabbits, hares, squirrels, rats, mice, and other small rodents. If a bat is found in a room where your child has been sleeping or playing, you should report it immediately to your pediatrician, even if you don’t find a bite mark. How Is the Diagnosis Made? Your pediatrician will examine your child. If rabies is suspected, a skin biopsy may be done to look for evidence of the virus. If your child develops encephalitis and lapses into a coma, a brain biopsy may be needed to confirm the diagnosis. Treatment There is no specific treatment for rabies once the infection develops in a child. There have been very few survivors of the infection. Therefore, prevention is extremely important. What Is the Prognosis? Rabies is almost always a fatal infection. Death is usually caused by respiratory or heart failure within days after the appearance of symptoms. However, prompt and proper treatment of bites can prevent or control the infection before it involves the brain and produces the serious symptoms. Prevention Following a bite, if your pediatrician determines that the animal has a high risk of having rabies, the doctor will immediately immunize your child with rabies immune globulin, a type of passive immunization. The globulin, disease-battling antibodies, is injected into the skin around the bite. At the same time, your pediatrician will give your child injections of the rabies vaccine, which stimulates the body to make its own antibodies against the infection. Your child will be given a series of 5 inoculations over a period of 4 weeks. If the animal is a domestic and healthy pet, your pediatrician will ask you to observe your child. The pediatrician will start the shots only if the animal shows signs of rabies. Teach your child to avoid contact with any stray or wild animals. Your child should not tease or bother an animal and shouldn’t examine or play with a dead animal that she may find. You can reduce the presence of wild animals in the area of your home by tightly closing garbage can lids. Chimney covers can prevent bats from getting into the home. Make sure your own family pet receives animal rabies shots according to your veterinarian’s recommendations. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
313,14,"2018-04-19 02:48:19","From Insects or Animals",313,"2018-04-19 03:31:06","Rat Bite Fever","Rat Bite Fever Page Content Article BodyRat-bite fever is a disease that occurs in humans who have been bitten by an infected rat or, in some cases, squirrels, mice, cats, and weasels. On occasion, the disease can also be spread by ingestion of contaminated food or milk products (Haverhill fever). Most cases in the United States are caused by bacteria called Streptobacillus moniliformis. Another form of rat-bite fever, caused by Spirillum minus, is almost always caused by a rat bite. It cannot be caught from food or milk and is rarely seen in the United States. Person-to-person transmission does not occur. The incubation period is 3 to 10 days in most cases of S moniliformis and 7 to 21 days in cases of S minus. Signs and Symptoms Rat-bite fever symptoms can vary depending on which organism is responsible for the disease. When the disease is caused by S moniliformis, the bite, which usually heals quickly, is followed 3 to 10 days later by: Fever and chills Headache Skin rash (mostly on the arms and leg ) Muscle pain Arthritis (particularly in the knees) Vomiting and diarrhea Complications (eg, abscesses, pneumonia, meningitis, heart inflammation) With infections caused by S minus, the site of the bite may appear to heal initially, but 7 to 21 days later, the following symptoms may surface: Fever and chills Headache Ulceration at the site of the bite with red streaks Swelling of the lymph nodes A skin rash with reddish-brown or purple plaques Muscle pain and arthritis (rare) Vomiting and sore throat (Haverhill fever) Complications (eg, infection of the heart, pneumonia, meningitis, hepatitis) Both forms of rat-bite fever may result in recurrent fevers, sometimes for months or years. How Is the Diagnosis Made? Your pediatrician can conduct tests such as cultures or smears of the blood or fluids from the site of the infection (eg, bite, lymph glands, joints) to find the bacteria responsible for rat-bite fever. Treatment To treat rat-bite fever, the doctor will give your child penicillin G by injection or intravenously for 7 to 10 days. Alternative drugs include ampicillin, cefuroxime, and cefotaxime. What Is the Prognosis? With prompt treatment, most children with rat-bite fever recover completely. Prevention Any animal bite should be cleaned well with soap and water. Treatment for 2 or 3 days with amoxicillin clavulanate by mouth may be helpful in preventing infection. The need for a tetanus vaccine should be reviewed. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
314,14,"2018-04-19 02:48:19","From Insects or Animals",314,"2018-04-19 03:31:10","Rocky Mountain Spotted Fever: Another Illness from Ticks","Rocky Mountain Spotted Fever: Another Illness from Ticks Page Content Article BodyRocky mountain spotted fever (RMSF) is a widespread infection that occurs throughout the continental United States. It is caused by Rickettsia rickettsii bacteria. Although the name implies that the disease is related to the Rocky Mountains, it is most commonly seen in the southeastern and south central states. The disease is spread to humans through the bite of an infected tick. Most often, the infected tick is a dog tick, but sometimes it can be a wood tick. Cases tend to occur from April through September. The disease most often affects children and teenagers younger than 15 years, especially those who spend time outdoors or have pets that might carry the ticks. Signs And Symptoms Children infected with RMSF first have symptoms common to many other infectious diseases, including flu-like symptoms such as fever, muscle pain, severe headaches, vomiting, nausea, and loss of appetite. A rash develops in most cases of RMSF, typically before the sixth day of the illness. This rash tends to appear first on the wrists and ankles, but within hours it can spread to the torso. It can also spread to the palms of the hands and soles of the feet. The rash is red, spotted, and raised. Other symptoms may include joint pain, stomach pain, and diarrhea. In severe cases, the blood pressure can drop and the patient may become confused. As the infection spreads, many organs, including the brain, can be affected. Laboratory findings include low platelet counts and a low sodium level. Symptoms usually appear about 1 week after the tick bite occurs. This incubation period, however, can range from 2 to 14 days. When To Call Your Pediatrician If your child has been exposed to ticks or you know she has been bitten by a tick, contact your pediatrician if your child develops any of these symptoms. How Is The Diagnosis Made? Your pediatrician will evaluate your child’s signs and symptoms and also use blood tests to confirm the diagnosis of RMSF. Laboratory findings that could help identify RMSF include decreased blood platelet count (thrombocytopenia), decreased concentration of sodium in the blood (hyponatremia), and increased level of liver enzymes (elevated transaminases). Treatment If your pediatrician suspects that your child has RMSF, the doctor will prescribe a course of antibacterials to be started immediately. Most often, doxycycline is the drug chosen to treat RMSF. Treatment with this medication usually continues for 7 to 10 days or until the child’s fever has been gone for at least 3 days. Although doxycycline and other tetracycline antibiotics are not normally used in children younger than 8 years, in this case, the need for treatment of the bacteria outweighs the small risk of staining the teeth. The other antibacterial used to treat RMSF is chloramphenicol. This drug is avoided when possible because of possible side effects affecting bone marrow. What Is The Prognosis? With early treatment, almost all children will recover completely from RMSF. Even without antibacterial therapy, most children recover. However, the infection can become severe and overwhelming. Although rare, certain patients may have long-term complications that include nerve damage, hearing loss, incontinence, partial paralysis of the lower extremities, and gangrene that can lead to the amputation of toes or fingers. Some children may die from RMSF. Prevention The best preventive measure is to keep your child away from areas where ticks are present, such as wooded areas and areas with brush and tall grass. If she spends time in tick-infested regions, apply an insect repellant containing DEET to her exposed skin, following product instructions. Do not use excessive amounts of DEET on children. Regularly inspect your child’s clothes and body for ticks, including the scalp and hair. If your child wears light-colored apparel, it will be easier to see ticks that may be crawling on her clothing. Don’t forget to check your pets for ticks. Ticks can be brought in to the house on the dog’s fur and spread to a child. Antibiotics should not be taken as a preventive measure after a tick bite because the risk for infection is so low. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
315,14,"2018-04-19 02:48:19","From Insects or Animals",315,"2018-04-19 03:31:17","Roundworm (Ascariasis)","Roundworm (Ascariasis) Page Content Article BodyA large roundworm, Ascaris lumbricoides is the cause of a parasitic infection of the small intestines called ascariasis. Humans are the preferred hosts for this parasite. Children become infected with this disease more often than adults. The illness often develops after a child puts his hands in his mouth after playing in soil contaminated by feces containing the roundworm eggs. Eating unwashed fruit or vegetables that were grown in contaminated soil can also cause ascariasis. Although the infection can occur in any part of the world, it is more common in developing countries with poor sanitation and areas where human feces are used as fertilizer. The entire life cycle for this parasite occurs within humans. The adult worm in the bowels of a child lays thousands of eggs a day, which then pass into the stools. In areas with poor sanitation or where human feces are used as fertilizer, the eggs will mature for 2 to 3 weeks in the soil and become infectious on the surface of unwashed fruits or vegetables. If a child plays in the contaminated soil, he can get the eggs directly onto his fingers and put his fingers into his mouth, or a person could eat the parasite’s eggs that may end up on the surface of unwashed vegetables. After the eggs hatch in the bowel, the larvae burrow through the bowel wall and into the bloodstream. The blood carries the larvae to the lung, where the parasites can enter the breathing sacs. The larvae then crawl up the breathing tubes and into the throat, where they are swallowed. Once they are back in the gut, the larvae mature to adult worms. Signs and Symptoms Most children with A lumbricoides infections do not have any signs and symptoms. Sometimes youngsters have stomach cramps and, in the more serious cases, even intestinal obstruction that could lead to vomiting. Worms that travel into the bile ducts can cause blockage and infection of the liver, pancreas, or both. When the roundworm’s larvae migrate through the lungs, they can cause an allergic lung inflammation (pneumonitis) along with fever, cough, and wheezing. Sometimes, the worms are seen coming out of the anus, mouth, or nose. When to Call Your Pediatrician Contact your pediatrician if your child has any of the symptoms or signs described here, especially if they continue to get worse. Let your doctor know if your child has traveled to parts of the world where parasitic infections are common (ie, areas of poor sanitation, the tropics). How Is the Diagnosis Made? Most often, this infection is diagnosed by seeing a worm or worms in the diaper or toilet bowl or detecting eggs in a sample of your child’s stool. The eggs are microscopic in size, while the worms are several inches in length and have an appearance similar to an earthworm. Treatment To treat A lumbricoides infections, your pediatrician may prescribe a single dose of medicine called albendazole or 3 days of pyrantel or mebendazole. These treatments should be given whether the infection causes symptoms. Surgery is occasionally needed to relieve an intestinal or bile duct blockage. What Is the Prognosis? With proper treatment, children fully recover from ascariasis. Prevention Reinfection is common. Keep your child away from soil that could be contaminated with human feces. Make sure you wash vegetables and fruits prior to eating. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
316,14,"2018-04-19 02:48:19","From Insects or Animals",316,"2018-04-19 03:31:21","Scorpion Stings","Scorpion Stings Page Content Article BodyScorpions look like miniature lobsters. They have pincers and a long up-curved tail with a poisonous stinger. Several species of scorpions live in the southwestern United States, but only the bark scorpion poses a threat to humans. Severe reactions to the sting of the bark scorpion are usually only seen in children. Some of these reactions are paralysis, spasms, or trouble breathing. The bark scorpion is pale tan in color. It is ¾ to 1 ¼ inches long, not including the tail. What to Look For: Pain in the area of the sting that gets worse in several minutes. Pain may travel up the limb that was stung.  Mild swelling. First Aid for Scorpion Stings:  Call EMS. Wash the sting site with soap and rinse with water.  Cover the area with a cloth and apply ice or a cold pack to the sting site to reduce pain. (Always protect the skin by wrapping ice or a cold pack in a thin cloth. Direct contact of extreme cold on the skin can cause tissue damage.) Last Updated 11/21/2015 Source First Aid for Families (PedFACTs) (Copyright © 2012 American Academy of Pediatrics)"
317,14,"2018-04-19 02:48:19","From Insects or Animals",317,"2018-04-19 03:31:26","Sick from Ticks: Human Ehrlichiosis","Sick from Ticks: Human Ehrlichiosis Page Content​Infections from ticks are on the rise in the United States. But while many parents know about Lyme Disease, fewer may be aware of other illnesses children can get from ticks. Fever, headache and other flu-like symptoms a week or two after being bitten by a tick, for example, could be symptoms of human ehrlichiosis infection.How is it Spread?Human ehrlichioses infections are caused by at least 3 different types of bacteria that are spread through bites of infected ticks—Ehrlichia chaffeensis, Ehrlichia ewingii, and Anaplasma spp. Lone star ticks(Amblyomma americanum), named for the single white dot on their backs, are the primary way humans are affected with ehrlichioses. In addition, lone star ticks are aggressive human biters—the most common tick reported to bite humans in the southeastern and southcentral United States. However, there have been reports of long star ticks in states as far north as Minnesota and New Hampshire. Deer ticks (Ixodes scapularis) and dog ticks (Dermacentor variabilis) also can be infected with and spread the bacteria causing human ehrlichioses.Signs and Symptoms: Ehrlichiosis infections have signs and symptoms similar to influenza (the flu), including: Fever Headache Chills Muscle and joint aches and pains Generally feeling sick and fatigued (malaise) Poor appetiteNausea and vomitingIn some cases, the child may also develop a rash, cough or confusion. These symptoms typically begin 5 to 10 days after the tick bite. It is important to remember that tick bites often go unnoticed. Many people with tick-borne infections do not realize that a tick has bitten them.What Parents Can Do: Call the pediatrician. Children, or their parents, may not notice if they've been bitten by a tick.  Call your pediatrician right away if your child has these symptoms—especially if the family recently spent time in nature areas. Your child may need lab tests and may receive a prescription antibacterial medication, usually doxycycline, if it turns out he or she has a human ehrlichiosis infection. Most children with ehrlichioses who are treated will recover completely within 1 to 2 weeks. Prevent exposure. Limit your child's exposure to ticks and bacteria they may carry as much as possible. Steps that can help include: Stick to the beaten path. Try to stay on the trail in wooded areas where ticks are known to be a problem. Avoid playing in tall grassy areas or those with a lot of leaves on the ground, habitats that ticks also love. Backyard basics. Keep lawns where children play mowed and raked. Try to set up play equipment, such as swing sets, in sunny, dry areas away from wooded edges of yards. Cover up. Dress your child in a hat and long-sleeved shirt and long pants that cover most of the body. Tuck pant legs into his or her socks. Use insect repellent. Apply an EPA-registered insect repellant to exposed skin in a ventilated area. For example, repellents containing 20-30% DEET are safe and effective when used as directed for children. Products containing plant-based picaridin can also be used on skin and can help keep ticks off. Reapply every 6 hours or according to label instructions. Permethrin products can be used to treat clothing and gear, but should not be applied to skin. Don't forget pets. Treat pets with tick repellents as advised by your veterinarian. Wash off. Bathing or showering after coming inside makes it easier to spot ticks that may be crawling or attached to the skin. Be sure to check less visible spots such as folds of skin, behind the ears, and the scalp. Remove ticks. Gently remove any ticks you see as soon as possible to minimize exposure to the bacteria they may carry. Using tweezers, pull straight out without twisting. After the tick is removed wash the area with soap and water. Use the dryer. To help kill ticks, put clothing right into the dryer, if possible, on high heat for at least 10 minutes.​​If you have any questions about tick-related illness, talk with your pediatrician.Additional Information & Resources: How to Remove A Tick Choosing an Insect Repellent for Your Child How to Build an Essential Summer First Aid Kit Lyme and Other Tickborne Diseases (Centers for Disease Control and Prevention) Ehrlichiosis (Centers for Disease Control and Prevention)​ Article Body Last Updated 9/29/2017 Source Section on Infectious Diseases and Council on Environmental Health (Copyright © 2017 American Academy of Pediatrics)"
318,14,"2018-04-19 02:48:19","From Insects or Animals",318,"2018-04-19 02:51:14","Snake Bites",
319,14,"2018-04-19 02:48:19","From Insects or Animals",319,"2018-04-19 02:51:14","Spider Bites",
320,14,"2018-04-19 02:48:19","From Insects or Animals",320,"2018-04-19 02:51:14",Tapeworms,
321,14,"2018-04-19 02:48:19","From Insects or Animals",321,"2018-04-19 03:34:57","Treatment for Animal Bites","Treatment for Animal Bites Page Content Article BodyMany parents assume that children are most likely to be bitten by strange or wild animals, but in fact most bites are inflicted by animals the child knows, including the family pet. Although the injury often is minor, biting does at times cause serious wounds, facial damage, and emotional problems.If your child is bleeding from an animal bite, apply firm continuous pressure to the area for five minutes or until the blood flow stops. Then wash the wound gently with soap and water, and consult your pediatrician. If the wound is very large, or if you cannot stop the bleeding, continue to apply pressure and call your pediatrician to find out where to take your child for treatment. If the wound is so large that the edges won’t come together, it probably will need to be sutured (stitched). Although this will help reduce scarring, in an animal bite, it increases the chance of infection, so your doctor may prescribe preventive antibiotics. Contact your pediatrician whenever your child receives an animal bite that breaks the skin, no matter how minor the injury appears. The doctor will need to check whether your child has been adequately immunized against tetanus or might require protection against rabies. Both of these diseases can be spread by animal bites. Like any other wound, a bite can become infected. Notify your pediatrician immediately if you see any of the following signs of infection:Pus or drainage coming from the biteThe area immediately around the bite becoming swollen and tender (It normally will be red for two or three days, but this in itself is not cause for alarm.)Red streaks that appear to spread out from the biteSwollen glands above the bite Your pediatrician may recommend antibiotic therapy for a child who has:Moderate or severe bite woundsPuncture wounds, especially if the bone, tendon, or joint has been penetratedFacial bitesHand and foot bitesGenital area bites Your pediatrician may recommend a follow-up visit to inspect any wound for signs of infection within forty-eight hours. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
322,14,"2018-04-19 02:48:19","From Insects or Animals",322,"2018-04-19 03:35:03","Tularemia: An Infection Caused by Insects","Tularemia: An Infection Caused by Insects Page Content Article BodySometimes called rabbit fever, tularemia is caused by the Francisella tularensis bacteria. It is spread to humans through the bites of infected insects—most often, ticks, mosquitoes, and deerflies. It can also be passed to people by direct contact with infected animals, including rabbits, cats, hares, and muskrats. Your child can get tularemia by consuming contaminated food or water, eating inadequately cooked meat, or breathing in the bacteria. It cannot be transmitted from person to person. Symptoms generally begin after an incubation period of usually 3 to 5 days, but possibly as long as 21 days. According to the Centers for Disease Control and Prevention, there are about 200 human cases of tularemia reported per year in the United States, mostly in rural regions. Most cases occur during the summer months, similar to tick season. Signs and Symptoms Tularemia can cause illnesses that vary depending on how the infection was spread. Most commonly, a painful ulcer develops in the skin at the site of the insect bite, with tender enlarged lymph glands in the groin or armpits. Sometimes the glands may enlarge with no apparent bite. Infection from food or water begins in the mouth with a severe sore throat, mouth sores, and enlargement of the neck lymph glands. With this form of the illness, your child may develop vomiting, diarrhea, and abdominal pain. Illness from inhalation of the bacteria mainly results in fever, chills, muscle aches, and a dry cough. When the infection enters through the eyes, it results in swollen and red eyes with tender lymph glands in front of the ears. In many cases, tularemia is seen as a combination of several of these symptoms. When to Call Your Pediatrician Call your pediatrician immediately if your child develops an illness that could be a sign of tularemia, especially if he has a high fever, chills, a skin ulcer, or enlarged lymph glands. Prompt treatment is very important with this infection. How Is the Diagnosis Made? Your pediatrician will take samples of your child’s blood and have them tested in the laboratory for antibodies to tularemia. Sometimes the bacteria can be grown from the blood or infected sites. Treatment The doctor will treat your child with an antibiotic such as streptomycin or gentamicin. Treatment usually lasts for a 10-day period, although sometimes longer for more serious cases. Early treatment of the infection is important. What Is the Prognosis? When children are treated with the appropriate antibiotics, their infection will quickly clear up, although relapses occasionally occur. If the infection goes completely untreated, however, it can be life threatening in some cases. Prevention You can protect your child from the bites that cause tularemia by making sure he wears protective clothing.  Also, inspect your child frequently for ticks and remove any that may have attached themselves to his skin or scalp. The use of insect repellents, particularly those that contain the chemical DEET, is also recommended. Use gloves, masks, and goggles when skinning or dressing wild animals. Other preventive measures include: Instruct your child not to handle sick or dead animals. Make sure all meat is cooked thoroughly before feeding it to your youngster. Ensure that drinking water comes from an uncontaminated source. A vaccine is not available to protect against tularemia, although interest in vaccine development has been growing since concerns have been raised about the use of the F tularensis bacteria as a bioterrorist weapon. This organism could be spread through an airborne route, at which point it could be breathed in and would need to be treated quickly with antibiotics. Last Updated 11/21/2015 Source Immunizations ＆ Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy of Pediatrics)"
323,14,"2018-04-19 02:48:19","From Insects or Animals",323,"2018-04-19 03:35:15","Wings and Stings","Wings and Stings Page Content Article BodyThose beautiful summer and early fall days that beckon us outdoors also often expose us to a lot of insects. And that includes stinging insects. Those stings often cause us brief moments of pain. But for some people, a sting can result in a serious, even deadly allergic reaction — including severe lung and breathing problems. That can be especially dangerous for a child who has asthma or other breathing challenges. “There are between 50 and 100 deaths a year from anaphylaxis as a result of stinging insects,” says John Kelso, M.D. FAAP, of the division of Allergies, Asthma and Immunology at San Diego’s Scripps Clinic. While this figure is low compared to the thousands of anaphylaxis deaths from food and drug allergies each year, many of the sting-related deaths could be prevented. Allergies and Asthma, Insects and Immunity Bees, wasps, hornets, yellow jackets, and imported fire ants are the prime villains in such cases. But it’s the nature of the victim’s immune system and sensitivity to the insect’s venom that triggers the reaction. In severe reactions, the child’s allergic immune response to the sting results in the air passages shrinking, making breathing difficult or impossible. Children experiencing anaphylaxis should receive emergency medical treatment immediately. Among the most common emergency treatments is epinephrine (eh-pih-NEH-frin) — another word for adrenalin — which helps open the airways by reducing the tightening of the muscle embedded in the airway. “The vast majority of people who are stung won’t have a serious reaction at all,” Kelso says, “much less an anaphylactic reaction. This is even true of those who have asthma or other lung diseases. And any patient experiencing anaphylaxis can display the symptoms of asthma, whether they actually have asthma or not.” However, if the person stung is allergic and has asthma or other lung disease, the reaction is potentially more dangerous. (See “Stinging Insects and Asthma” below.)Is Your Child at Risk? How do you know if you or your children are allergic to insect stings? “A prior exposure to what causes the reaction (the allergen) is necessary in order to be allergic,” Kelso says. “You have to have been stung and had some kind of reaction.” For patients whose insect-sting allergy has been established, Kelso recommends several courses of action. “Venom immunotherapy is one approach to dealing with the allergy,” Kelso notes. Patients who receive this treatment are injected with small doses of the allergen — bee venom, for instance — which gradually strengthen their immune system’s resistance to the venom’s effects. Many professional beekeepers, for example, have been stung so frequently that their immune systems barely react to the venom. “It’s also a good idea for people allergic to insect stings to carry a self-injectable dose of epinephrine in order to be prepared for an anaphylactic emergency,” Kelso says. Parents of allergic children should make sure that teachers and school staff members, camp counselors, coaches, and other activity supervisors are aware of the child’s allergy. Facilities should be equipped with epinephrine and other needed emergency treatments. The best defense against potentially dangerous insect stings is, of course, not to get stung. “Avoidance is the best treatment for all allergic diseases,” Kelso says. He recommends that people remain alert when outdoors for anthills, bee swarms and nests, as well as areas that attract large populations of mosquitoes and other flying insects. “If you’re allergic, be careful about outdoor strolls and gatherings, such as picnics,” he adds. “Don’t pick up empty soda cans or other trash that might attract insects. Don’t go barefoot. Don’t wear flowery scents. Try to look and smell as little like a flower as possible.” Stinging Insects and Asthma The vast majority of asthma patients aren’t allergic to insect stings and won’t experience a severe anaphylactic reaction if stung, notes Dr. John Kelso of Scripps Clinic’s division of Allergy, Asthma and Immunology in San Diego. But what if you do have both asthma and an allergy to insect venom? “If you superimpose an anaphylactic event on top of asthma,” Kelso says, “your chances of dying are increased.” As many as two-thirds of the 50 to 100 annual anaphylaxis deaths from stinging insects are in patients who have both asthma and an allergy to stings. Similarly high asthma-patient figures are noted in the far higher number of anaphylactic deaths from non-insect causes, such as allergies to peanuts, penicillin, and other food and drug allergies. As with non-asthma patients who are allergic to stinging insects, asthma patients need to be prepared and vigilant in situations that could expose them to insect stings. Asthma sufferers should take extra precautions during insect season. It’s wise to carry an injectable dose of epinephrine, to manage asthma as effectively as possible, and to avoid locations and events likely to attract stinging insects. In other words, you don’t necessarily have to avoid the outdoors. But you should do everything possible to avoid exposing yourself to the stinging residents you may find there.This article was featured in Healthy Children Magazine. To view the full issue, click here. Last Updated 11/21/2015 Source Healthy Children Magazine, Allergy/Asthma 2007"
324,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",324,"2018-04-19 03:35:22","Blocked Urethral Valves","Blocked Urethral Valves Page Content Article BodyUrine leaves the bladder through a tube called the urethra, which in boys passes through the penis. Rarely, small membranes form across the urethra in boys early in pregnancy, and they can block the flow of urine out of the bladder. These membranes are called posterior urethral valves and can have life-threatening consequences by causing blockage of normal urine flow interfering with development of the kidneys. If there is abnormal kidney development, there can be abnormal development of the lungs. The severity of posterior urethral valves can vary widely. Most cases are diagnosed before birth with a screening ultrasound. This condition may be suspected in boys if there appears to be a decrease in the amount of amniotic fluid. Consulting a pediatric urology specialist is always advisable before the baby is born. In boys who are not diagnosed before birth with posterior urethral valve, sometimes the newborn exam may reveal that the baby’s bladder is distended and enlarged. Other warning signals include a continual dribbling of urine and a weak stream during urination. More commonly though, posterior urethral valve is diagnosed when the boy develops a urinary tract infection with fever and poor feeding. If you notice these symptoms, notify your pediatrician at once. Posterior urethral valves require immediate medical attention to prevent serious urinary tract infections or damage to the kidneys. If the blockage is severe, the urine can back up through the ureters (the tubes between the bladder and the kidneys), creating pressure that can damage the kidneys. Treatment If your child has a posterior urethral valve, your pediatrician may pass a small tube (catheter) into the bladder to relieve the obstruction temporarily and allow the urine to flow out of the bladder. Then he’ll order X-rays and/or an ultrasound of the bladder and kidneys to confirm the diagnosis and to see if any damage has occurred to the upper urinary tract. Your pediatrician will consult with a pediatric nephrologist (kidney specialist) or nurologist, who may recommend surgery to remove the obstructing valves and prevent further infection or damage to the kidneys or urinary system. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
325,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",325,"2018-04-19 03:35:26","Blood in Urine (Hematuria)","Blood in Urine (Hematuria) Page Content Article BodySometimes my child's urine looks reddish in color. Is that normal? If your child’s urine has a red, orange, or brown color, it may contain blood. When the urine specifically contains red blood cells, doctors use the medical term hematuria to descibe this condition. Causes Many things, including a physical injury or inflammation or infection in the urinary tract, can cause it. Hematuria also is associated with some general medical problems, such as defects of blood clotting, exposure to toxic materials, hereditary conditions, or immune system abnormalities. Sometimes there may be such small amounts of blood in the urine that you cannot see any color change, although it may be detected by a chemical test performed by the pediatrician. In some cases the reddish color is not associated with hematuria at all, and the reddishness may be due simply to something your child has eaten or swallowed. Beets, blackberries, red food coloring, phenolphthalein (a chemical sometimes used in laxatives), or phenazopyridine (medicine used to relieve bladder pain), and the medicine rifampin may cause the urine to turn red or orange if your child ingests them. Anytime you are not sure that one of these alternative explanations is responsible for the color change, call your pediatrician. Blood in the urine, when accompanied by protein (albumin), is usually due to inflammation of the filtering membranes of the kidney; the general term for this condition is nephritis. Your doctor may recommend further tests to distinguish among several different kinds of nephritis. Treatment Your pediatrician will ask you about any possible injury, foods, or health symptoms that might have caused the change in urine color. He will perform a physical examination, checking particularly for any increase in blood pressure, tenderness in the kidney area, or swelling (particularly of the hands or feet or around the eyes) that might indicate kidney problems. He also will perform tests on a sample of urine and may order blood tests, imaging studies (such as an ultrasound scan or X-rays), or perform other examinations to check the functioning of your child’s kidneys, bladder, and immune system. If none of these reveals the cause of the hematuria, and it continues to occur, your pediatrician may refer you to a children’s kidney specialist, who will perform additional tests. (Sometimes these tests include an examination of a tiny piece of kidney tissue under the microscope, a procedure known as a biopsy. This tissue may be obtained by surgically operating or by performing what’s called a needle biopsy.) Once your pediatrician knows more about what is causing the hematuria, a decision can be made whether treatment is necessary. Often no treatment is required. Occasionally medication is used to suppress the inflammation that is the hallmarksign of nephritis. Follow-up is important Whatever the treatment, your child will need to return to the doctor regularly for repeat urine and blood tests and blood pressure checks. This is necessary to make sure that she isn’t developing chronic kidney disease, which can lead to kidney failure. Occasionally hematuria is caused by kidney stones, or, rarely, by an abnormality that will require surgery. If this is the case, your pediatrician will refer you to a pediatric urologist who can perform such procedures. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
326,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",326,"2018-04-19 03:35:32","Children with a Single Kidney","Children with a Single Kidney Page Content Article Body​Like the eyes and the lungs, most of us have two kidneys. However, as many as 1 in 1,000 infants are born with only one functioning kidney. In the past, most individuals did not know they had one kidney, and did not have any health issues. Today most women have an ultrasound during their pregnancy and most infants with a single kidney are discovered before they are born. An even larger group of infants have only one functioning kidney due either to severe malformation or obstruction of the other kidney.Why Does This Happen? For most infants with a single kidney, we do not know why this happens. Occasionally, it is part of a larger problem with other organs affected, called a syndrome. For the vast majority of infants, no identifiable cause can be found, although it occasionally can be associated with maternal diabetes and certain medications taken during pregnancy. This is one of the reasons for getting early prenatal care.Is it Genetic? For the majority of families of a child with a single kidney, the risk of a second child with a similar problem is very low, but this should be discussed with your pediatrician or obstetrician who may refer you to a genetics counselor.  What are the Long Term Problems for a Person with a Single Kidney? Most people with a single kidney lead full and normal lives, provided that kidney is normal. This is why a person with two kidneys can donate one kidney to a person with kidney failure. A healthy single kidney typically grows faster than a normal kidney and will be bigger than a normal kidney. This extra growth is good and helps the single kidney to do the work of two kidneys.  However, the single kidney is not always formed properly. Your child’s pediatrician will perform tests to detect any problems with that kidney. These may include: Blood tests to check the function of that kidney. Imaging studies such an ultrasound to make sure the kidney tissue looks normal and there is no stretching where the urine collects in the kidney. Voiding cystourethrogram (VCUG) to make sure the urine doesn’t go back up into the kidney when the infant voids or that there is any blockage to the flow out of the bladder. Nuclear medicine study to check the function of the kidney and make sure the urine is getting out of the kidney and into the bladder normally. Blood Pressure & Urine Checks A few individuals with a single kidney may develop kidney problems later in life such as high blood pressure or protein in the urine. The American Academy of Pediatrics (AAP) recommends infants and children with a single kidney should have their blood pressure checked each year and their urine tested for protein as part of their routine well-child care. Adults with a single kidney should also have periodic checks of their blood pressure and urine.   What About Playing Sports? Fortunately, the kidneys are located deep in the body and are less likely to be injured compared to the head, spleen, or liver. The AAP recommends that children and adolescents with a single kidney be allowed to play most sports. This decision, however, should be based on several factors, such as the: Advice of your pediatrician Current heath of your child Sport in which he is participating Position he would play Level of competition Maturity of your child Relative size of the other participants in contact/collision sports Availability of protective equipment Whether the sport can be modified to allow safer participation Ability of your child’s coach to understand and accept the risks involved in participation Padding designed specifically to protect the kidney should also be considered when making this decision, although little is known on its effectiveness.   What Should Parents of a Child with a Single Kidney Do? Children with a single kidney should be treated no differently than other children. They do not need special diets. They, like children with two kidneys, need regular well-child care as recommended by the AAP.    Additional Resources: High Blood Pressure in Children Proteinuria Medical Conditions That May Rule Out Sports Participation Prevention is The Best Medicine: Sports Safety Guidelines Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2013)"
327,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",327,"2018-04-19 03:35:38","Detecting Urinary Tract Infections","Detecting Urinary Tract Infections Page Content Article BodyHow do I know if my child has a urinary tract infection? Urinary tract infections (UTIs) are common in young children. UTIs may go untreated because the symptoms may not be obvious to the child or to parents. Normal urine has no germs (bacteria). However, bacteria can get into the urinary tract from two sources: the skin around the rectum and genitals and the bloodstream from other parts of the body. Bacteria may cause infections in any or all parts of the urinary tract, including the following: the urethra (called ""urethritis"") the bladder (called ""cystitis"") the kidneys (called ""pyelonephritis"") UTIs are common in infants and young children. About 3 percent of girls and 1 percent of boys will have a UTI by 11 years of age. A young child with a high fever and no other symptoms, has a 1 in 20 chance of having a UTI. The frequency of UTIs in girls is much greater than in boys. Uncircumcised boys have slightly more UTIs than those who have been circumcised. Symptoms Symptoms of UTIs may include the following: fever pain or burning during urination need to urinate more often, or difficulty getting urine out urgent need to urinate, or wetting of underwear or bedding by a child who knows how to use the toilet vomiting, refusal to eat abdominal pain side or back pain foul-smelling urine cloudy or bloody urine unexplained and persistent irritability in an infant poor growth in an infant Treatment UTIs are treated with antibiotics. The way your child receives the antibiotic depends on the severity and type of infection. If your child has a fever or is vomiting and unable to keep fluids down, the antibiotics may be put directly into the bloodstream or muscle using a needle. This is usually done in the hospital. Otherwise, the antibiotics can be given by mouth, as liquid or pills. UTIs need to be treated right away for the following reasons: to get rid of the infection to prevent the spread of the infection to reduce the chances of kidney damage Infants and young children with UTIs usually need to take antibiotics for 7 to 14 days, sometimes longer. Make sure your child takes all the medicine your pediatrician prescribes. Do not stop giving your child the medicine until the pediatrician says the treatment is finished, even if your child feels better. UTIs can return if not fully treated Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
328,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",328,"2018-04-19 03:35:41","Explaining Disorders of Sex Development & Intersexuality","Explaining Disorders of Sex Development & Intersexuality Page Content Article Body​​The first question new parents ask is ""Is it a boy or a girl?"" However, for an estimated 1 in 2,000 children born each year, this is a difficult question to answer. These are children born with a disorder of sex development (DSD) – a group of about 60 conditions in which biological sex, or being male or female, is not clear. Before birth, in the first weeks of pregnancy, females and males look nearly identical. Then, because of a complicated interaction between genes and chemicals called hormones, the differences we have come to expect slowly take shape.   What is a Disorder of Sex Development? A DSD is a mismatch between a child's chromosomes, or genetic material, and the appearance of the child's genitals. A child may present with a DSD in infancy, childhood or adolescence. Previously, DSDs were called ""intersex"" conditions. This means ""between the sexes."" However, this term felt uncomfortable to some people with who identified themselves as strongly male or strongly female. Note: Most people with a DSD prefer the term ""Difference"" of Sex Development rather than ""Disorder,"" because the word ""disorder"" implies that there is something ""wrong"" with the person rather than a natural variation. Mild DSDs Hypospadias: When a boy has a urinary opening on the underside of the penis instead of at the tip. Clitoromegaly: When a girl's clitoris is larger than average. Significant DSDs Ambiguous genitalia: When it is not clear whether a child is male or female by looking at the genitals.  What Causes DSDs? A genetic change that may or may not be inherited from a parent. Unknown exposure to certain medications or hormones during pregnancy. A developmental problem in the baby during pregnancy that prevents the production of enough of his or her own hormones (e.g. lack of blood flow to the ovaries or testes).A developmental problem that causes the bladder or lower abdomen to not form properly (e.g. cloacal exstrophy).There is No One To Blame The most important thing to realize is that it is not the fault of the parent that a child has a difference of sex development. Parents have no control over which genes are passed on to a child, or whether there is a developmental problem causing a DSD. The best thing to do for a child is to love and accept them as they are. Medical Management: A Team Approach A team of medical professionals may be involved in the care of a child born with a DSD, depending on the severity. This team consists of pediatric specialists in: Endocrinology Surgery Urology Psychology and PsychiatryGynecology Genetics Neonatology Social workNursingMedical ethicsInfants with ambiguous genitalia, for example, may see all of the pediatric specialists mentioned above. Which doctors each child needs depends on his or her own characteristics.Treatment The family and the team of doctors will determine the best way to help the child have a happy and healthy life. This may include treatment with medications or surgery. In some cases, there is no treatment needed. It is important to discuss the risks and benefits of each treatment thoughtfully with the child's future well-being in mind. If it is not medically necessary, any irreversible procedure can be postponed until the child is old enough to agree to the procedure (e.g. genital surgery). DSD & Gender IdentityThe medical community used to think that gender identity (the feeling that a person is a boy or a girl), was learned or taught. However, we now know it is influenced by genetics, exposure to hormones while still in the mother's uterus and other factors that are not known yet. For example: Some girls with Androgen Insensitivity Syndrome actually have a Y chromosome typical for a boy, but their body does not respond typically to the testosterone produced. They develop as, and often identify as, girls.  Some girls with a condition called Congenital Adrenal Hyperplasia produce too much testosterone. These girls can show behaviors more typical for boys, but most of them still identify as girls. Most individuals with mild DSDs identify with the gender that is consistent with their chromosomes; boys if they have an X and a Y chromosome, and girls if they have two X chromosomes. However, in children with ambiguous genitalia, where it is not possible to tell if the child is a boy or a girl from the outside, the child's gender identity may not be easy to predict.Determining the Gender of a Child with a Significant DSDDetermining the gender of a child with a significant DSD or ambiguous genitalia is especially challenging when the child is too young to say whether they feel like a boy or a girl. In this case, the parents and the medical team will work together and gather as much information as possible about what the future may hold for the child.  Regardless of the male or female gender assigned at birth, sometimes the team and the family are incorrect. In this case, once the child is old enough to state his or her own identity, he or she may choose to live that gender instead.  Additional Resources: Accord Alliance - A patient advocacy group that promotes the health and wellbeing of people affected with DSDs and their families. The AIS-DSD Support Group - A network dedicated to children and adults with Androgen Insensitivity Syndrome and other DSDs. Answers to Your Questions About Children with Intersex Conditions (American Psychological  Association) Sex Development: An Overview (The Hospital for Sick Children in Toronto, Canada) - An interactive demonstration of sex development including movies, diagrams, and illustrations to help individuals understand how and why DSDs happen. Last Updated 11/21/2015 Source Provisional Section on Lesbian Gay Bisexual Transgender Health and Wellness (PSOLGBTHW) (Copyright © 2014 American Academy of Pediatrics)"
329,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",329,"2018-04-19 03:35:50","Hypospadias: A Birth Defect of the Penis","Hypospadias: A Birth Defect of the Penis Page Content Article BodyIn boys, the opening through which urine passes (the meatus) is located at the tip of the penis. A condition known as hypospadias is a birth defect that leaves the opening on the underside of the penis. There also may be an abnormal bending of the penis called chordee, which may cause sexual problems in adulthood. The meatus (the opening where urine passes) may direct the urinary stream downward and cause the stream to spray. A concern of many parents is the abnormal appearance of the penis in severe hypospadias, which can be a source of embarrassment to boys as they grow older. Treatment After detecting hypospadias in your newborn, your pediatrician probably will advise against circumcision until after consultation with a pediatric urologist or surgeon. This is because circumcision makes future surgical repair more difficult. Mild hypospadias may require no treatment, but moderate or severe forms require surgical repair. At this time, most children with hypospadias undergo outpatient surgery at around six months of age. In severe cases, more than one operation may be needed to repair the condition completely. After surgery your child’s penis will appear nearly normal and he’ll be able to urinate normally and—when he’s older—have sexual relations. Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
330,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",330,"2018-04-19 03:35:55","Kidney Cysts in Infants, Children & Teens","Kidney Cysts in Infants, Children & Teens Page Content Article Body​Kidney cysts are round pouches of fluid that form in the kidneys and are typically less than 1 inch in diameter. The simple kidney cyst is different from the cysts that develop when a person has polycystic kidney disease (PKD), a genetic disease.Simple Kidney Cysts Simple kidney cysts are often detected during an imaging test (e.g. ultrasound, CT, MRI) being done for another condition, because they rarely cause pain or other symptoms. It is not clear what causes simple kidney cysts, although the risk of having one increases with age. Simple kidney cysts in children are rare.Complex Kidney Cysts While cysts are commonly a simple sack of fluid, they can have multiple chambers, like a bag of grapes. These cysts are called complex, or septated, cysts. Septations are walls within the cyst. Having many or thick walled septations suggests a low but possible cancer risk. If the cyst is complex, your doctor may repeat the imaging test a few months later to be sure it is not growing and becoming cancerous.Multicystic Dysplastic Kidney Multicystic dysplastic kidney (MCDK) is a condition that occurs when a kidney is not put together correctly when it forms in the womb. The result is a non-functioning kidney full of cysts and scar tissue. Fortunately, the remaining kidney is usually able to take over all kidney function. In infants with MCDK, however, the remaining kidney may have an abnormality. Your doctor may do more tests to evaluate this kidney. Incidence: MCDK affects 1 in every 4,000 babies. Diagnosis: 70% of MCDK cases are diagnosed by ultrasound before a baby is born. Prevention: There is no way to prevent MCDK from occurring early in a baby's development, and there is no known way to prevent it from happening later in life. Outlook: A baby with MCDK and no other birth defects has a normal life expectancy. For a child with only one kidney that works, that kidney may be a little bigger than normal. She will need follow-up care for life to make sure the kidney remains healthy. Polycystic Kidney Disease Kidney cysts can also be caused by a genetic mutation. The most common form of this is PKD, in which cysts can replace the kidney over time and cause kidney failure. There are two forms: autosomal dominant (ADPKD) and autosomal recessive (ARPKD). Autosomal Dominant Polycystic Kidney DiseaseLarge kidney cysts are associated with ADPKD. They often begin to appear in childhood, although most affected children and teens have no symptoms until they are adults.    Incidence: ADPKD affects 1 in 500. It does not skip a generation. There is usually a family history of ADPKD. A parent with ADPKD has a 50% chance of passing the disease on to each of their children. Symptoms: Often the first sign is high blood pressure, blood in the urine, or a feeling of heaviness or pain in the back, sides, or abdomen. Sometimes, the first sign is a urinary tract infection (UTI) and or kidney stones. Diagnosis: Children with a family history of ADPKD should have periodic urinalyses and blood pressure measurements to identify early manifestations of the disease. It is not recommended for otherwise healthy children and teens to have kidney-imaging tests done, regardless of whether a parent has ADPKD. One reason is that it may adversely affect the child’s insurability, even if there are no symptoms yet. Routine genetic testing of potentially affected children and teens is also not recommended. Note: These recommendations may change with advances in the treatment of ADPKD.      Outlook: There is currently no accepted therapy to prevent cysts from forming or enlarging. Autosomal Recessive Polycystic Kidney DiseaseEnlarged kidneys with tiny cysts are associated with ARPDK. Sometimes, the kidneys are so large and function so poorly that infants are born with severe respiratory problems and do not survive.   Incidence: ARPKD is relatively rare and occurs in 1 in 20,000.   Diagnosis: Most ARPKD cases are diagnosed by ultrasound before a baby is born. Outlook: Most children with ARPKD have high blood pressure and progressive kidney failure. They will need to be on kidney dialysis and or receive a kidney transplant by late childhood to survive. A number of these children will also develop liver disease, leading to esophageal bleeding and ultimately liver failure.    Physical Activity & Children with Cystic Kidney DiseaseVery large cysts can rupture with minor trauma and lead to blood in the urine and occasionally severe hemorrhaging. Your child's doctor will help decide if physical activity should be limited. It is possible that children with large kidneys and/or large cysts will have more episodes of blood in the urine if they play contact sports, such as football. Outlook for Children with Kidney CystsThe number of cysts a child has affects his signs and symptoms. In most children, kidney cysts grow very slowly, if at all, and cause no problems. Therefore, there is no treatment needed. If a cyst becomes very large, it may cause side or stomach pain or interfere with the kidney's function. However, it is extremely rare to do surgery on a cyst. Typically, a cyst is removed or drained if it is infected and not responding well to antibiotics or is causing significant pain. A pediatric nephrologist and a pediatric urologist work together to decide whether to remove kidney cysts. Note: Surgery can only remove a limited number of cysts in children with cystic kidney disease. After surgery, the smaller cysts can continue to enlarge. This means the surgery is not the final treatment and further care is needed for long-term management.Additional Information: Children with a Single Kidney What is a Pediatric Nephrologist? Your Family Health History & Genetics Kidney Stones in Children and Teens American Society of Pediatric Nephrology National Kidney Foundation Last Updated 11/21/2015 Source Section on Nephrology (Copyright © 2014 American Academy of Pediatrics)"
331,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",331,"2018-04-19 03:36:02","Kidney Stones in Children and Teens","Kidney Stones in Children and Teens Page Content Article Body​Kidney stones are hard concretions of the minerals and other elements normally found in urine. The stone typically forms in the kidney before it passes down the tubes connecting the kidney to the bladder. Rarely, stones may form in the bladder. While kidney stones can occur at any age, even in premature infants, most occur in teens, with teen girls having the highest incidence. Types of Kidney Stones There are many different types of kidney stones in children, but the most common one in the United States contains calcium in association with other materials. The stones range in size from a fraction of an inch to several inches, with most around ¼ - ½ inch in size.   Causes of Kidney Stones In most children and teens, kidney stones are due to the diet and/or amount of fluid the child drinks. In some children, however, they are the result of a:   Specific inherited problem Blockage of urine flow Kidney infection Signs and Symptoms The most common sign of a kidney stone in older children and teens is the sudden onset of pain in the back or side. The pain is usually constant and severe, and often causes nausea and vomiting. This pain may move into the groin area as the stone passes down the urinary tract. Most of the time, this causes blood to appear in the urine. Often this is only detectable by testing the urine for blood but sometimes it is visible to the naked eye.   Young children with kidney stones are usually unable to tell exactly where the pain is and just complain that their tummy hurts. A number of young children will have no pain at all and the stones are discovered during the evaluation of a urinary tract infection or as an unexpected finding on an x-ray or ultrasound study done for another reason.   How Is the Diagnosis Made? While the location and severity of the pain and the presence of blood in the urine are suggestive of a kidney stone, the diagnosis rests on finding a stone in the urinary tract by an x-ray or an ultrasound. Sometimes, the diagnosis is made by capturing the stone in the urine after it has been passed.   Many stones can be seen with a simple x-ray of the abdomen and most can be seen with an ultrasound of the kidneys. A CT scan can show the smallest stones but exposes the child to more radiation. If you or your doctor suspects your child has a kidney stone, he or she can help you decide what method is needed in order to make a diagnosis.   Treatment Once a stone is discovered, the initial goal is to help your child pass the kidney stone out of the urinary tract by drinking large amounts of water and other fluid. In a sense, they are trying to “flush it out.” If your child cannot keep fluid down because of the pain and nausea, it may be necessary to have the fluid given through an IV. Often, medicine is given to help reduce the pain.   Stones larger than a ½ inch may require surgery or lithotripsy to remove them. Lithotripsy uses a special machine to send sound waves into your child to smash the stone into much smaller pieces that can then be passed down the urinary tract. While it may sound scary, it is quite safe and doesn’t damage the kidney. Lithotripsy can even be done in small children, although a child may be put to sleep for the procedure.   Prevention The best treatment is to prevent new stones from forming. All children with kidney stones should: Drink a lot of fluid throughout the day Limit the salt in their diet Limit the amount of soda or soft drinks they consume Your doctor may ask you to collect all the urine your child passes for 24 hours to test it for specific factors that may predispose your child to kidney stones. With this information, your doctor will better understand why your child formed a stone and be able to make specific dietary recommendations or prescribe certain medications to help prevent your child from making another kidney stone. Your doctor may also recommend that your child see a pediatric nephrologist or urologist who has experience in treating children with kidney stones.  Last Updated 11/21/2015 Source American Academy of Pediatrics (Copyright © 2012)"
332,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",332,"2018-04-19 03:36:06","Labial Adhesions","Labial Adhesions Page Content Article BodyOrdinarily the lips of skin (labia) surrounding the entrance to the vagina are separated. In rare cases, they grow together to block the opening, partially or completely. This condition, called labial adhesions (sticking together of labia), may occur in the early months of life or, less frequently, later on if there is constant irritation and inflammation in this area. In these latter cases, the problem is usually traceable to diaper irritation, contact with harsh detergents, or underwear made with synthetic fabric. Usually labial adhesions do not cause symptoms, but they can lead to difficulty with urination and increase a girl’s susceptibility to urinary tract infections. If the vaginal opening is significantly blocked, urine and/or vaginal secretions will build up behind the obstruction. Treatment If the opening of your daughter’s vagina appears to have closed or looks partially blocked, notify your pediatrician. He will examine your child and advise you whether any treatment is necessary. The majority of such adhesions resolve on their own as the child gets older and require no treatment. At first, your doctor will attempt to spread the labia gently. If the connecting tissue is weak, this mild pressure may expose the opening. But if the connecting tissue is too strong, the doctor may prescribe a cream that contains the female hormone estrogen for you to apply to the area as you very gently and gradually spread the labia apart over a period of time. Once the labia are separated, you will need to apply the cream for a short while (three to five days) until the skin on both sides heals completely. Occasionally some adhesions return once the cream is discontinued. However, they usually disappear permanently in early childhood. In rare cases, the adhesions (scarlike tissue that grows between the labia and holds them together) are so thick that they block the flow of urine. In this situation, they will need to be separated by a physician, such as a pediatric urologist. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
333,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",333,"2018-04-19 03:36:10","Meatal Stenosis","Meatal Stenosis Page Content Article BodyIn boys the meatus is the opening through which urine passes. Sometimes, particularly in circumcised boys, irritation of the tip of the penis causes scar tissue to form around the meatus, making it smaller. This narrowing, called meatal stenosis, may develop at any time during childhood, but is most commonly found between ages three and seven. Meatal stenosis is relatively rare. Boys with meatal stenosis have a narrowed and abnormally directed urinary stream. The stream is directed upward (toward the ceiling), making it difficult to urinate into the toilet without pushing the penis down between the legs. Your son may take longer to urinate, and have difficulty emptying his bladder completely. Treatment If you notice that your son’s urinary stream is very small or narrow, or if he strains to urinate or dribbles or sprays urine, discuss it with your pediatrician. Meatal stenosis is not a serious condition, but it should be evaluated to see if it needs treatment. In some cases, a steroid cream can be applied to the penis to correct the problem. If an operation is needed, this surgery is very minor and usually requires only local anesthesia. Your child will have some minor discomfort after the procedure, but this should disappear after a very short period of time. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
334,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",334,"2018-04-19 03:36:13","Menstrual Disorders in Teens","Menstrual Disorders in Teens Page Content Article Body Within a year or two of their first period, 50 to 75 percent of young women begin to experience painful menstrual cramps, or dysmenorrhea.Some cases of dysmenorrhea are eventually traced to the gynecologic disorder endometriosis, in which endometrial tissue is located in sites within the pelvic cavity other than the uterus. However, the majority of girls can be reassured that the cramping is related to the production of prostaglandins by the uterus, which is easily remedied.Heavy and irregular bleeding, referred to as dysfunctional uterine bleeding (DUB), can indicate serious underlying medical problems in teens. DUB is caused by a disturbance involving the hormones that regulate menstruation, but it is generally painless. But if it's not treated, patients can lose so much blood that they develop severe anemia.Symptoms of Dysmenorrhea:Severe crampingOccasional sharp pains in the lower abdomen, lower back and thighsSweatingFatigueHeadacheFaintnessNausea and vomitingDiarrheaHow Dysmenorrhea is Diagnosed:Physical examination and thorough medical history (including menstrual history).Symptoms of Dysfunctional Uterine Bleeding:Bleeding more frequently than every twenty-one days (counting from the first day of one period to the first day of the next), less frequently than every thirty-five to forty-two days, or longer than seven days. Teens with these types of menstrual bleeding patterns should be medically evaluated.How Dysfunctional Uterine Bleeding is Diagnosed:Physical examination, including pelvic exam, and thorough medical history, plus one or more of the following procedures, to test for related complications or evidence of a mass or a sexually transmitted disease (STD).Complete blood count (CBC)Thyroid function testsSTD laboratory testsPregnancy testMeasurement of gonadotropins, prolactin and androgensHow Menstrual Disorders are treated with Drug Therapy:After exclusion of specific medical conditions, girls may be placed on medications. The cramping of dysmenorrhea is typically addressed with NSAID (nonsteroidal anti-inflammatory drug) analgesics such as ibuprofen, ketoprofen or naproxen. These medications block the uterus from releasing prostaglandins, naturally occurring chemicals that cause cramps. Oral contraceptives can also be used to relieve severe menstrual cramps. Hormone treatments, such as oral contraceptives, can also be used for dysfunctional uterine bleeding. NSAIDs may reduce bleeding to some extent, as well.Additional Information: Concerns Girls Have About Puberty Effective Birth Control for Sexually Active Teens http://youngwomenshealth.org  Last Updated 11/5/2015 Source Adapted from Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
335,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",335,"2018-04-19 03:36:22","Nocturnal Enuresis in Teens","Nocturnal Enuresis in Teens Page Content Article BodyBy adolescence, only 4 percent of boys and 2 percent of girls wet the bed; the figures fall to 1.5 percent and 0.5 percent by age eighteen. So you can appreciate how distressing it is to be one of those teenagers who is still experiencing urinary incontinence at night. In most cases the lack of bladder control has been a problem since birth, as opposed to having resurfaced after six months or more of dryness. The former condition is called primary nocturnal enuresis; the latter, secondary nocturnal enuresis. How Nighttime Incontinence is Evaluated The cause for nocturnal enuresis is multifactoral. Contributing factors may include poor dietary control with excessive caffeine intake, a deep sleep pattern that can be part of normal adolescent development, inconsistent sleep schedule and limited hours sleeping. Other influencing factors include: Medications Caffeine Urinary-tract infections Diabetes and other chronic medical problems Family history Primary nocturnal enuresis often follows a similar pattern. It is helpful to identify the age of nocturnal continence for both parents. If one parent was incontinent through a particular age, their children will have a similar problem approximately 40 percent of the time. If both parents have primary nocturnal enuresis through a particular age, their children have a 70 percent chance of following a similar pattern. Secondary enuresis in older children or adolescence should prompt a review for urinary-tract infections, major medical illnesses, social stress factors and the potential for sexual abuse. How Nighttime Incontinence is Treated Treatment of nocturnal enuresis is based on differentiating primary from secondary nocturnal enuresis. Any factor that resulted in secondary nocturnal enuresis would need to be managed prior to concentrating on the enuretic event. A child who actively participates in their treatment has a better chance to improve their outcome. Practical Approach It is first important to educate the child and family on appropriate dietary intake. While totally restricting fluids is not practical, eliminating products with caffeine is essential and recommending moderate intake is appropriate. The child needs to routinely use the bathroom prior to going to bed and immediately upon waking in the morning. You can wake your teenager once during the night so he can urinate if necessary, but waking him more than once a night may disrupt his sleep pattern, which could lead to diminished school performance the following day. Behavior Modification Behavior modification through the use of an enuretic alarm is effective in approximately 70 percent of motivated children. The device contains moisturesensitive sensors that result in buzzing or vibrating. Typically the expense for these alarms is sixty to a hundred dollars. This form of therapy requires active participation by an adult and long-term commitment. Strong office support should be provided in follow-up. Medications There are only two medications that have been approved for nocturnal enuresis—imipramine and desmopressin. The exact action of imipramine is not completely understood, but it has been shown to be effective in approximately 50 percent of enuretic children. The dosing of imipramine is somewhat arbitrary and the family should be advised regarding the potential toxicity for overdose of the medication. A baseline EKG prior to initiating therapy is recommended although cardiac side effects have not been reported with doses used to treat bed-wetting. The family should also maintain strict control over dispensing the medication because of the potential for overdosing. Desmopressin (DDAVP) is a synthetic antidiuretic hormone (ADH). Its mechanism of action is similar to ADH and is effective in improving nocturnal enuresis in approximately 40 to 60 percent of children. DDAVP is available in both nasal spray and pill forms. When continued long term, expense can become an issue with medication costing $80 to $120 for a month’s supply. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
336,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",336,"2018-04-19 03:36:28","Prevent Urinary Tract Infections in Children","Prevent Urinary Tract Infections in Children Page Content Article BodyChildren usually need to pass urine more often than adults because their bladders are smaller and they tend to drink more fluids relative to their size. In addition, young children may feel the need to pass urine more urgently because it takes a long time—several years—to develop mature control of the muscles that open and close the bladder. If a child has pain on urination, a urinary tract infection (UTI) is the most likely reason, but several other conditions can also cause pain.Call Your Pediatrician Right Away If Your Child:Cannot pass urineIs passing bloody urineHas a swelling in the abdomen and difficulty urinatingHas pain on urinationIs urinating with unusual frequencyIs having daytime or nighttime wetting after achieving a pattern of drynessWarning!Some children who have pain from recurrent UTIs are in the habit of passing urine infrequently. They may also be severely constipated. Train your child to respond promptly when she feels the urge to use the bathroom.Preventing UTIsPain on urination is most often caused by infection. Girls are particularly susceptible to UTIs, because their urethras are very short and germs from the bowel can easily pass along this route to the bladder. To reduce the risk of infection, girls should always wipe from front to back after bowel movements. A popular home remedy for infections is drinking cranberry or blueberry juice. Studies show that these fruits contain substances that make the urine more acidic and stop bacteria from growing. However, drinking plenty of plain water to flush out the bladder may be just as effective. Other helpful measures include the following:Wear cotton underpants and avoid very tight-fitting jeans and other pants.Avoid bubble baths, perfumed soaps, and other substances that can irritate the genitals and urethra.After swimming, change into dry clothes instead of sitting around in a wet suit.Avoid foods and beverages that can cause bladder irritation. Common offenders include colas and other caffeinated drinks, chocolate, and some spices.Common Concerns from Parents""My toilet-trained child is urinating often or with greater urgency. She has started wetting her bed or underclothes after a long dry period. She is having abdominal pain. Her urine smells bad. She has blood in her urine. She has pain or burning on urination.""Possible cause: UTIWhat parents should do: Call your pediatrician. If a bacterial infection is present, it must be treated promptly to prevent complications. If the infection is caused by a virus, antibiotics won't help, but the infection should clear up by itself in about 4 days. In the meantime, your pediatrician will recommend ways to keep your child comfortable.""My baby's urine has an unpleasant smell. She is feverish and fretful.""Possible cause: UTIWhat parents should do: Call your pediatrician, who will examine your baby, perform diagnostic tests including a urine culture, and prescribe appropriate treatment. Last Updated 11/21/2015 Source The Big Book of Symptoms: A-Z Guide to Your Child’s Health (Copyright © 2014 American Academy of Pediatrics)"
337,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",337,"2018-04-19 03:36:32",Proteinuria,"Proteinuria Page Content Article BodyA child’s urine sometimes can contain abnormally high amounts of protein. Although the body needs proteins to perform essential functions, such as guarding against infections and helping the blood to clot, protein detected in the urine may mean that the kidneys are not working properly and are allowing proteins (which are large molecules) to leak out into the urine. This may be due to inflammation of the kidney’s filtering membranes, allowing this leakage to occur. Diagnosis Proteinuria often causes no symptoms. But when high levels of protein are in the urine, blood protein levels may drop and your child could develop swelling in the legs, ankles, abdomen, or eyelids. Blood pressure may be elevated. If your pediatrician suspects proteinuria, she can use a simple test in which a chemically treated paper strip is dipped into the urine, and will change colors if protein is present. She may recommend that you collect urine samples from your child just after awakening in the morning, and that the urine specimens be examined in the laboratory, or that your child have some blood tests. In some children, a small amount of protein may be found in the urine for a short time and later disappear without any consequences. At times, your pediatrician may decide to have your child seen by a kidney specialist (nephrologist), who might recommend performing a kidney biopsy to help decide what may be causing the problem. During a kidney biopsy, a needle is used to remove a small amount of kidney tissue for examination in the laboratory. Your child will be sedated for this procedure and the area over the kidney will be made numb by injecting a local anesthetic. Treatment Medication can be given to treat some underlying kidney problems associated with proteinuria. Your pediatrician might recommend that your child consume less salt to curtail the swelling associated with proteinuria. Children who have had proteinuria, even if it appears to be one of the harmless varieties, probably will be monitored over time with regular urine tests. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
338,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",338,"2018-04-19 03:36:37","Testicle Pain & Testicular Torsion","Testicle Pain & Testicular Torsion Page Content Article BodyTesticular Pain in Teens Could Be a Sign of Testicular TorsionThe most important thing to know about testicular torsion is that it is an emergency that must be treated immediately. But, it can be difficult for teenage boys to talk about their testicles or tell a parent if they are having pain. Boys need to know that any genital pain is serious and should not be ignored. Ignoring testicle pain for too long or simply hoping it goes away can result in severe damage to the testicle and even its removal.Time is critical! If your son has pain in his testes, take him to the emergency room right away. The time from the start of symptoms until treatment is the most important factor in being able to save the testicle. The longer someone waits to seek treatment, the greater the risk of permanent injury.  If treated within 6 hours of the start of pain à over 90% chance of saving the testicle.If treated after 24 hours of pain à​ less than 10% chance of saving the testicle. This includes the time it takes to get to a hospital, get evaluated, and get treated.  What is Testicular Torsion?Testicular torsion most often occurs in teenage boys and is the most common pediatric emergency of the genitourinary tract. Boys usually have two testicles sitting in the scrotum, and each one hangs from a cord – the spermatic cord. The cord carries important structures such as blood vessels, which give the testicle oxygen. If the cord were to twist, the testicle would lose its blood supply and oxygen. The pain is excruciating, but somehow many boys or their parents try to ignore it.  That denial comes at a cost. If the torsion isn't corrected quickly, the testicle may die. 30-40% of cases of testicular torsion results in loss of the testicle. What are Symptoms of Testicular Torsion?The symptoms of testicular torsion may involve one or both of the testes. The following are the most common symptoms of testicular torsion. However, each child may experience symptoms differently. Symptoms may include:Pain in the scrotum (Usually on one side, sudden, and severe) Swollen, red, tender scrotumEnlarged testicle Abdominal painNausea or vomitingNot all severe scrotal pain is torsion, but since the cause of pain isn't known until a boy is evaluated, all cases of severe scrotal pain need to be treated as an emergency.Who is At Risk for Testicular Torsion? Age: It most commonly occurs in teenage boys, shortly after puberty, however it can occur in younger children. It is uncommon over the age of 25. Family history: Having a relative who had torsion increases the risk of torsion, (but this is not always known).  Setting: Torsion can occur at any time (even when asleep). Sometimes, torsions happen from a sports injury. Wearing a cup for any contact or high-impact sport may help prevent torsion or other injuries to the testicle.How is Testicular Torsion Diagnosed? Physical examination Scrotal Doppler ultrasound (a wand-like instrument  placed on the scrotum to assess blood flow to the testicles)Some urologists will take a patient with typical symptoms of torsion directly to the operating room.How is Testicular Torsion Treated?Immediate surgery to untwist the testicle is required to potentially save the testicle. After untwisting, the testicle is secured in the proper position. If the torsion has caused too much damage, the testicle may need to be removed. It may also be necessary to secure the other testicle to prevent it from twisting. Some urologists may untwist the testicle with a bedside maneuver before surgery, but surgery is still required.Can Testicular Torsion Fix Itself?Occasionally, a testicle can twist and untwist. This is called intermittent torsion. In intermittent torsion, severe pain may suddenly appear and then just as suddenly get better. This type of pain still needs to be evaluated by a healthcare professional for several reasons:Most torsions don't improve on their own. Waiting for the testicle to untwist increases the risk of losing a testicle.Even after untwisting, the testicle is at risk for a future episode of torsion.Sometimes the untwisting is not complete and there is less blood reaching the testicle, which causes damage even though the pain is much better.  Twisting and untwisting can still injure the testicle, even if it doesn't cause loss of the testicle.When one side has torsion, the other testicle is at higher risk for torsion. Both sides need to be evaluated and possibly treated. Not all scrotal pain is a torsion. Pain that comes and goes may be due to other causes, which also need to be evaluated.What if a Testicle Needs to Be Removed?The testicle is removed (orchiectomy) if the torsion is severe, the blood supply is lost, and the tissue in the testicle dies. Fortunately, only one testicle is generally needed to carry out the functions of a testicle: Making hormones (testosterone) Contributing to pregnancy So, even if someone loses a testicle to torsion, they are still usually able to carry out these functions. However, in some rare cases, testicular torsion can increase the risk for infertility. Testicular Implants While there is nothing to be ashamed about in losing a testicle, loss of a testicle can be emotionally difficult for some boys. At a later time, if you and your son desire a more cosmetic appearance, testicular implants exist that can be placed surgically.What Should Parents of Teen Boys Keep in Mind? While it may be awkward to discuss genital anatomy with your preteen and teenage son, they need to know that any pain in their genitals is an emergency. Talk to your son about the risks of keeping severe scrotal pain a secret.Reassure him that there is nothing to be embarrassed about.Encourage him to tell you or an adult if they are having sudden, severe scrotal pain. This is the best way to prevent loss of a testicle.Watch and share this video  School health programs and or to anyone wishing to educate a friend or relative about testicular torsion are encouraged to watch this video for additional information. Testicular Torsion - Dr. Ariella Friedman from PATV on Vimeo. Last Updated 11/21/2015 Source Section on Urology (SOU) (Copyright © 2015 American Academy of Pediatrics)"
339,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",339,"2018-04-19 03:36:41","Undescended Testicles","Undescended Testicles Page Content Article BodyDuring a woman’s pregnancy, the baby boy’s testes develop in his abdomen. As he nears birth, they descend through a tube (the inguinal canal) into the scrotum. In a small number of boys, especially those who are premature, one or both testicles fail to descend by the time of birth. In many of these boys, descent will occur during the first few months of life. In some, however, this does not happen. Most boys will have a normal retraction of the testes under certain situations, such as while sitting in cold water (i.e., the testes “disappear” temporarily up into the inguinal canal). However, in general, when the boy is warm, testes should be low in the scrotum. The cause of most cases of undescended testicles is unknown. If your child has undescended testicles, his scrotum may be small and appear underdeveloped. If only one testicle is undescended, the scrotum may look asymmetrical (full on one side, empty on the other). If the testicles sometimes are in the scrotum and at other times (i.e., when he is cold or excited) are absent, and located above the scrotum, they are said to be retractile. This condition usually self-corrects as a boy grows older. Rarely the undescended testicle may be twisted, and in the process, its blood supply may be stopped, causing pain in the inguinal (groin) or scrotal area. If this situation is not corrected, the testicle can be damaged severely and permanently. If your son has an undescended testicle and complains of pain in the groin or scrotal area, call your pediatrician immediately. Undescended testicles should be reevaluated at each regular checkup. If they do not descend into the scrotum by one year of age, treatment should be considered. Treatment Undescended testicles may be treated with hormone injections and/or surgery. Currently, hormonal treatment is limited to cases of a very low undescended testis or some retractile testes. Many children with true undescended testes will also have an inguinal hernia and the hernia will be repaired at the same time that the undescended testis is moved to the scrotum. If your son’s undescended testicle is allowed to remain in that position for over two years, he has a higher than average risk of being unable to father children (infertility). He also has a slightly increased risk of developing testicular tumors in adult life, particularly if the testicle is left in its abnormal position. Fortunately, with early and proper treatment, all of these complications usually can be avoided. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
340,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",340,"2018-04-19 03:36:45","Urinary Tract Infections in Teens","Urinary Tract Infections in Teens Page Content Article BodyThe urinary tract begins with the kidneys, two bean-shaped organs that skim waste products and excess water from the blood to create urine. A pair of narrow tubes called the ureters carries the urine to the baglike bladder for storage. From there it travels down another tube, the urethra, and leaves the body through the penis or the vulva. In the process, the urine washes away germs from the opening of the urinary system. But sometimes microorganisms slip into the urethra and begin to multiply and inflame its inner lining. The culprit behind most urinary-tract infections (UTIs) is Escherichia coli (E. coli), a bacteria that resides in the intestinal tract. An infection confined to the urethra is called urethritis. However, many times the germs continue upward, landing in the bladder. Cystitis, the most common UTI, frequently occurs in tandem with urethritis. If not treated promptly, the infection can spread to the ureters and the kidneys. The medical term for this more serious condition is pyelonephritis. Young women develop urinary-tract infections at more than three times the rate of young men. One probable reason why is that the female urethra, at just one and a half inches long, affords germs easy access to the bladder. The male urethra, in contrast, measures eight inches in length. A second factor is the close proximity of the urethral opening to the vagina and anus, both of which serve as fertile environments for bacteria. During intercourse, germs from the vagina may be pushed into the bladder. In fact, as Dr. Alain Joffe points out, a UTI may be a sign that a teenager is sexually active. “There is a significant overlap between the symptoms of urinary-tract infections and the symptoms of chlamydia, gonorrhea and other sexually transmitted diseases,” says the director of adolescent medicine at Baltimore’s Johns Hopkins School of Medicine. Symptoms That Suggest A Urinary-Tract Infection May Include: Pain or burning sensation when urinating Frequent urge to urinate, though only a small amount is passed Fever and chills Pressure sensation Pain in the abdomen, pelvis or lower back Nausea and vomiting Blood or pus in the urine Urinary incontinence How a Urinary-Tract Infection is Diagnosed Physical examination and thorough medical history, plus one or more of the following procedures: Urinalysis, to detect the presence of bacteria and white blood cells (wbc’s) Urine culture, to determine which antibiotic can be used to treat it How a Urinary-Tract Infection is Treated Drug therapy: Three days on an oral antibiotic usually clears up infections of the lower urinary tract. Once the kidneys are involved, however, treatment takes longer. Among the drugs most commonly ordered: trimethoprim, trimethoprim/sulfamethoxazole, amoxicillin, ampicillin, ofloxacin and nitrofurantoin. Additional medications may be prescribed to relieve pain and inflammation. Approximately one in five female sufferers will experience at least one subsequent urinary-tract infection. The new illness usually stems from a different strain of E. coli or an entirely different bacteria. Helping Teenagers Help Themselves The following measures may help prevent urinary-tract infections:Drink the equivalent of eight glasses of water a day. Don’t resist the urge to urinate, void at frequent intervals (every 3 to 4 hours). Urinate after sexual intercourse. Change tampons and sanitary napkins frequently. Do not douche. Wipe front to back, or from urethra/vagina toward the anus. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
341,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",341,"2018-04-19 03:36:51","Vaginal Infections","Vaginal Infections Page Content Article BodyYeast infections are caused by the fungus Candida albicans, one of many fungi that reside harmlessly in the vagina, mouth, throat and skin. The slightly acidic chemical content of the vagina controls the balance between the bacteria and yeast that reside in the normal vagina. If the fragile balance between acidity and alkalinity is altered, the amount of yeast grows to the extent that a Candida infection (known as candidiasis) occurs. A similarly uneasy truce exists between “friendly” bacteria (lactobacilli) and “unfriendly” bacteria (anaerobes). In bacterial vaginosis, the anaerobes multiply at a rapid pace until they’ve all but displaced many of the lactobacilli. As in candidiasis, the vaginal ecosystem changes from acidic to alkaline. “Nobody is absolutely sure what causes the bacterial overgrowth,” says Dr. Meg Fisher, a pediatrician at St. Christopher’s Hospital for Children, in Philadelphia. Interestingly, although bacterial vaginosis is not transmitted via intercourse, sexually active women have a higher rate of infection—and higher still if they’ve been intimate with multiple partners. Physical examination, including pelvic exam, and thorough medical history, plus one or more of the following procedures: Microscopic laboratory analysis of vaginal fluid (your pediatrician may refer to these tests as wet preparation and KOH preparation) to rule out infection.    How Vaginal Infections are Treated Drug therapy: Yeast infections are managed with antifungal agents suchas butoconazole, clotrimazole, miconazole and tioconazole, which come in the form of creams, ointments and suppositories. Fluconazole can be given orally. The shortest course consists of a single dose, which is 80 percent effective. For bacterial vaginosis, the antibiotics clindamycin and metronidazole are the mainstays of therapy. Vaginal Infection Symptoms   Bacterial Vaginosis Vaginal Yeast Infection Grayish-whitish milky discharge White, thick, curdlike discharge Foul odor often described as ""fishy""; most noticeable aftersexual intercourse No odor Occasional itching and/or burning Extreme itching and/or burning, especially when urinating Inflammation, redness and swelling of the outer lips of the vagina (labia)and the surrounding skin (vulva) Discomfort during and/or after sexual intercourse   Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
342,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",342,"2018-04-19 03:36:59",Varicocele,"Varicocele Page Content Article BodyAs part of your periodic parent-son chats about sex and sexual development, stress that any sort of genital pain or swelling is cause for concern and should be brought to the immediate attention of Mom, Dad or the pediatrician. One source of scrotal swelling is a varicocele within the scrotum. Like all veins, the veins in the spermatic cord have pairs of flipper like valves interspersed along the inner walls. Their job: to keep blood moving in one direction, toward the heart. Any time the circulation starts to flow backward, the flaps of the valves swing shut. Varicocele is set in motion when one or more valves fail to close properly. As a result, stagnant blood builds up in the vessel until the wall becomes swollen. The distended scrotal sac is said to resemble a “bag of worms”: a reference to the bulging vessels inside. A varicocele most often develops on the left side of the scrotum. Symptoms That Suggest Varicocele May Include: Most varicoceles are painless and do not cause symptoms. Occasionally one may experience dull, persistent ache or sensation of heaviness in the scrotum—often most noticeable after physical exercise. There may be a reduction in testicular size (atrophy). How Varicocele is Diagnosed The condition is diagnosed through physical examination and thorough medical history, including probing or palpating the area with the fingers. No radiographic studies are needed unless there is concern about obstruction as a cause. An ultrasound is done if the examiner feels the testicle on the affected side is too small. The varicocele may be apparent when standing. How Varicocele is Managed Most pubertal or prepubertal varicoceles do not need to be treated. However, if the varicocele is associated with pain during physical exercise, repair may be needed. Even if there is no pain, the potential for problems of infertility, which has been noted in men with a varicocele, may cause some doctors to suggest surgical repair. There is no absolute test or study that will predetermine which child is at risk for infertility based on his varicocele. Some physicians would encourage repairing a varicocele if there is a noticeable size discrepancy between the two testicles. Therefore, it is important to closely monitor the growth and development of both testicles as a child progresses through puberty. When surgical correction has been recommended, the procedure can be performed in an outpatient setting. Recovery takes about one week; however, it will be another five weeks, on average, before full recovery can be expected. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
343,15,"2018-04-19 02:48:19","Genitals & Urinary Tract",343,"2018-04-19 03:37:04","Yeast Infections in Girls and Young Women","Yeast Infections in Girls and Young Women Page Content​Kids might think it’s funny that yeast - a different type, but related to the kind found in bread - normally lives in small amounts in our bodies. But there’s nothing amusing about the discomfort that occurs when body yeast, called Candida, overgrows in common spots like moist skin, the mouth (thrush), the intestinal track and, perhaps most uncomfortably, the genital area.Yeast infections in the vagina and surrounding area are common in girls and women. In fact, it’s estimated that about 75 percent of all females will get a yeast infection at some point. The infection usually isn’t serious, but can be bothersome. Symptoms often include itching, burning, and a clumpy white discharge. What Causes Yeast Infections?Yeast infections may arise when the balance of microscopic organisms that normally co-exist in the body become unbalanced. Some possible causes for this include: Antibiotics. Yeast infections may develop after taking antibiotics. Antibiotics are prescription medicines used to fight harmful bacteria that can make a child sick. Antibiotics may also kill some of the body’s “good” bacteria, such as Lactobacillus acidophilus, that usually keep the Candida in balance.  Hormones. Changing hormone levels that begin during puberty can lead to yeast infections. Older girls are more likely to get a yeast infection right before their periods, for example.  Some birth control medications can also increase infections, with Candida growth tied to higher estrogen levels.Underlying Conditions. Poorly controlled diabetes can make a child more likely to develop yeast infections, since higher blood sugar levels may promote Candida growth. Immune Response. A weakened immune system caused by other illnesses or certain medications can make it difficult to fight off Candida that’s overgrowing.TreatmentYeast is actually a fungus, so your pediatrician can prescribe topical anti-fungal creams, ointments or suppositories to clear up an infection.  For yeast infections that return frequently, the pediatrician may prescribe oral medications. Can Yeast Infections Be Dangerous?Yeast infections usually aren’t dangerous unless Candida gets into the bloodstream and spreads to other parts of the body. Bloodstream infections are most common in newborns, especially low-birthweight babies, who can acquire the infection from their mothers before or during birth.Children with medical conditions who receive treatments involving catheters, or whose immune systems are weakened by illnesses or certain medications, also are at higher risk. If candidiasis has spread through the blood to other parts of the body, your pediatrician will usually recommend treatment with an intravenous (IV) medication. PreventionWise Antibiotic Use.  It may be difficult to prevent all yeast infections, especially when caused by antibiotics, which your child may need for common bacterial ailments such as ear infections and strep throat. But make sure all antibiotics are taken only as prescribed. Your pediatrician or pharmacist may recommend taking probiotics supplements to rebuild beneficial bacteria in the body such as Lactobacillus acidophilus, which help keep Candida in balance.Focus on Health.  Make sure your child eats a nutritious diet, gets enough sleep, and knows how to manage stress. These and other healthy habits can help keep the immune system strong so it can fight off Candida overgrowth and other infections. See your pediatrician regularly to stay on top of routine health issues and conditions such as diabetes, which can contribute to yeast infections if not well controlled.Stay Clean and Dry. Because yeast thrives in moist conditions, it may help to wear underwear made of cotton or other breathable fabric. Avoid materials like nylon that can trap heat and moisture, and make sure clothing isn’t too tight. Teach younger children who are potty training to wipe from front to back to avoid spreading microbes from the intestinal track to the vaginal area. Other considerations. Teens using an antifungal cream, ointment or suppository who are sexually active should not have sex until the infection is completely gone.  Topical medications can weaken condoms and diaphragms. Also, while yeast infections are not considered a sexually transmitted disease, the infection can be spread during sexual activity. Douching also should be avoided, because it can affect the balance of beneficial bacteria in the vagina that helps keep yeast from taking over.RememberIf you notice your child scratching a lot, talk to your pediatrician before surrounding skin becomes raw and open to bacterial infections. Be sure to mention if yeast infections are frequent so underlying medical conditions can be ruled out.Additional Information:Vaginal Infections Urinary Tract Infections in Teens Article Body Last Updated 1/31/2018 Source American Academy of Pediatrics (Copyright © 2018)"
344,16,"2018-04-19 02:48:19","Glands & Growth",344,"2018-04-19 03:37:09","Abnormal Breast Growth in Boys & Girls","Abnormal Breast Growth in Boys & Girls Page Content Article BodyBoth boys and girls have breast tissue. Normal breast development first appears shortly after birth, and then again at the beginning of puberty. The timing of breast development varies greatly from one person to another and in some girls may not occur until well into the teenage years. Here's an overview of some of the main breast abnormalities that can occur in children.  Even Infants Have Breast Tissue! Baby girls and boys will have a small breast bud that can be felt for a few weeks after they are born. These buds of tissue will become the breast tissue in the adult. In early infancy, they can be prominent because of the effects of the mother's estrogen. As the estrogen levels decrease, so does the prominence. Nipple discharge in infantsSome babies will have discharge from and redness and swelling around the nipples and most times this will resolve spontaneously. Nipple discharge in an infant is not a reason to stop breastfeeding. Bring up any concerns with your child's doctor. Extra NipplesOne of the most common breast abnormalities is extra nipples (also called supernumerary nipples) commonly found in the armpits or on the abdomen in both boys and girls. This extra tissue is called polythelia. If it is bothersome, it can be removed – typically with numbing medicine in the doctor's office at an age when the child wants to have it done.Enlarged Breasts in Boys Gynecomastia is the presence of enough breast tissue in a male to appear like a breast mound is developing. Gynecomastia can range from prominent breast bud tissue that does not go away to a feminized breast with a mound and rounded nipple. Half of all teenage boys will have tender, prominent tissue in the nipple area during puberty. In most cases this tissue will go down in size over 2-3 years. If it does not, and the boy is otherwise healthy, consideration can be given to removing the tissue surgically.It is important to note that some substance abuse, including marijuana use, can aggravate the condition. It is not uncommon for teen boys with this abnormality to become self-conscious or bullied. Although breast growth in boys is often hereditary, parents should seek medical attention to look for any hormonal or endocrine imbalance. Unusually Large Breasts in Girls Macromastia is the word to describe girls' breasts that are disproportionately large compared to the rest of their body. Large breasts can cause a teen girl not only emotional distress but also physical distress. For example, large breasts can be associated with upper back pain, tingling in the arms, and skin irritation. Socially they can be burdensome as teenagers, and they can restrict athletic participation. Initially, management is with physical therapy, skin care, proper bra fitting, and pain medicine as needed. Breast reduction surgeries When breast size causes other problems or interferes with activities, surgery can be considered. Typically, this is two to three years after a girl's menstrual cycles have begun and after shoe size stops changing. Reduction mammoplasty surgeries, as they are called, are typically done as outpatients under general anesthesia. Activities are limited for four to six weeks, but usually girls are back at school by the next week. Surgery of this type may or may not be covered by medical insurance, depending on symptoms, duration, response to physical therapy, body-mass index (BMI), and the amount of tissue that is removed to reduce the breast size.Breast Asymmetry Up to 25 percent of teens will have breasts growing in an asymmetrical fashion, and many women reach full maturity with one breast that is larger than the other. Sometimes, this is because they are shaped differently and grow differently. Other times, when a benign mass called a fibroadenoma is present in the breast, it is removed to allow the breast to return to its normal size. Other cases of asymmetry require consideration about how to balance the breasts. Balancing can be a combination of enlarging one side, reducing one side, or working on both sides. While parents or teens who are concerned should seek a medical evaluation, padded bras can often provide camouflage.Breast Masses in Children and Teens Because of heightened awareness of breast cancer, any lump in a child often creates a great deal of anxiety. Breast cancer is extremely rare before the age of 20; less than 0.1% of all breast cancer occurs in children or teens. Ultrasound studies can help determine whether a lump is a cyst that can be drained or a fibroadenoma. If your child has a breast mass, talk to your child's doctor. He or she can refer you to a pediatric specialist or pediatric plastic surgeon who specializes in caring for growth problems in breast tissue. Breast operations on young girls should be carefully undertaken because of the risk of adverse effects upon future breast development.All girls should be taught breast self-examination once their breasts are developing and they are going through their menstrual cycles. This should be the beginning of a lifelong habit.Absence of Breast DevelopmentWhen a girl does not have breast tissue by the age of 13, her breast development is considered delayed. Although rare, the breast bud may be nonexistent due to a chest wall deformity or failure of the underlying pectoralis muscle to develop properly. Girls with chronic illnesses like Crohn's disease, Turner syndrome, or an eating disorder may also fail to grow buds by the age of 13. See Delayed Puberty in Girls: Information for Parents. Additional Information: Physical Development in Girls: What to Expect Physical Development in Boys: What to Expect Concerns Girls Have About Puberty Last Updated 2/1/2016 Source Section on Plastic Surgery (Copyright © 2015 American Academy of Pediatrics)"
345,16,"2018-04-19 02:48:19","Glands & Growth",345,"2018-04-19 03:37:12","Acquired Hypothyroidism in Children","Acquired Hypothyroidism in Children Page Content​​​What does hypothyroidism mean?Hypothyroidism refers to an underactive thyroid gland that does not produce enough of the active hormones T3 and T4. This condition can be present at birth or can be acquired any time during childhood or adulthood. Hypothyroidism is very common and occurs in about 1 in 1,250 children. In most cases, the condition is permanent and will require treatment for life. About the thyroid gland:The thyroid gland is a butterfly-shaped organ located in the middle of the neck. It is responsible for producing the thyroid hormones T3 and T4. This production is controlled by the pituitary gland in the brain via thyroid stimulating hormone (called TSH). T3 and T4 perform many important actions during childhood, including the maintenance of normal growth and bone development. Thyroid hormone is also important in the regulation of metabolism.What causes acquired hypothyroidism?The causes of hypothyroidism can arise from the gland itself or from the pituitary. The thyroid can be damaged by direct antibody attack (autoimmunity), radiation, or surgery. The pituitary gland can be damaged following a severe brain injury or secondary to radiation. Certain medications and substances can interfere with thyroid hormone production. For example, too much or too little iodine in the diet can lead to hypothyroidism. See the American Academy of Pediatrics (AAP) policy statement, Iodine Deficiency, Pollutant Chemicals, and the Thyroid: New Information on an Old Problem, for more information. Overall, the most common cause of hypothyroidism in children and teens is direct attack of the thyroid gland from the immune system. This disease is known as autoimmune or Hashimoto's thyroiditis.Who is at the greatest risk?Certain children are at greater risk of hypothyroidism; this includes children with congenital syndromes, especially Down syndrome, children with type 1 diabetes, and children who have received radiation for cancer treatment.What are the signs and symptoms of hypothyroidism?The signs and symptoms of hypothyroidism include:TirednessModest weight gain (no more than 5-10 lb)Feeling coldDry skinHair lossConstipationPoor growthOften, your doctor will also be able to palpate an enlarged thyroid gland in the neck. This is called a goiter.How is hypothyroidism diagnosed?Simple blood tests are used to diagnose hypothyroidism. These include the measurement of hormones produced by the thyroid gland and pituitary. Free T4 (which is more accurate than just the total T4) and TSH are measured. The tests are inexpensive and widely available at your regular doctor's office. Hypothyroidism is diagnosed when the stimulating hormone from the pituitary (TSH) is high and the free T4 produced from the thyroid is low. If there is not enough TSH, then both levels will be low. Normal ranges for free T4 and TSH are somewhat different in children than adults, so the diagnosis should be made in consultation with a pediatric endocrinologist.What is the treatment for hypothyroidism?Hypothyroidism is treated using a synthetic thyroid hormone called Levothyroxine. This is a once-daily pill that is usually given for life. There are very few side effects, and when they do occur, it is usually the result of significant overtreatment. Your doctor will prescribe the medication and then perform repeat blood testing. We wait at least 6-8 weeks, because it takes a long time for the body to adjust to the new hormone levels. If the medication is working, blood testing will show normal levels of TSH and free T4.You should contact your doctor if your child experiences difficulty falling asleep or restless sleep or difficulty concentrating in school. These may be signs that your current thyroid hormone dose may be too high and you are being over treated.There is no cure for hypothyroidism; however, hormone replacement is safe and effective. With once-daily medication and close follow-up with your pediatric endocrinologist, your child can live a normal, healthy life.  Article Body Last Updated 6/21/2016 Source Copyright © 2014 American Academy of Pediatrics and Pediatric Endocrine Society"
346,16,"2018-04-19 02:48:19","Glands & Growth",346,"2018-04-19 03:37:16","Congenital Hypothyroidism in Infants","Congenital Hypothyroidism in Infants Page Content​What is congenital hypothyroidism?Hypothyroidism refers to an underactive thyroid gland. Congenital hypothyroidism occurs when a newborn infant is born without the ability to make normal amounts of thyroid hormone. The condition occurs in about 1 in 3,000-4,000 children, is most often permanent and treatment is lifelong. Thyroid hormone is important for your baby's brain development as well as growth, therefore, untreated congenital hypothyroidism can lead to intellectual disabilities and growth failure. However, because there is excellent treatment available, with early diagnosis and treatment, your baby is likely to lead a normal, healthy life.What causes congenital hypothyroidism?Congenital hypothyroidism most often occurs when the thyroid gland does not develop properly, either because it is missing, is too small, or ends up in the wrong part of the neck. Sometimes the gland is formed properly but does not produce hormone in the right way. Also, sometimes the thyroid is missing the signal from the pituitary (master) gland, which tells it to produce thyroid hormone. In a small number of cases, medications taken during pregnancy, mainly medications for treating an overactive thyroid, can lead to congenital hypothyroidism, which is temporary in most cases. Congenital hypothyroidism is usually not inherited through families. This means if one child is affected, it is unlikely that other children you may have in the future will suffer from the same condition.What are the signs and symptoms of congenital hypothyroidism?The symptoms of congenital hypothyroidism in the first week of life are not usually obvious. However, sometimes when hypothyroidism is severe, there may be:Poor feedingExcessive sleepingWeak cryConstipationProlonged jaundice (yellow skin) after birthIn these babies, the doctor may find a puffy face, poor muscle strength, and a large tongue with a distended abdomen and larger-than-normal fontanelles (soft spots) on the head.How is congenital hypothyroidism diagnosed?Given the difficulty in diagnosing congenital hypothyroidism in the newborn period based on signs and symptoms, all hospitals in the United States, under the supervision of state health departments, screen for this disease using blood collected from your baby's heel before discharge from the hospital. This process is called newborn screening. See the American Academy of Pediatrics (AAP) policy statement, Update of Newborn Screening and Thereapy for Congenital Hypothyroidism, for more information. When there is a positive result (a low level of thyroid hormone with a high level of thyroid-stimulating hormone, called TSH, from the pituitary), the screening program immediately notifies the baby's doctor, usually before the baby is 2 weeks old. Before starting treatment, your baby's doctor will order a blood sample from a vein to confirm the diagnosis of congenital hypothyroidism. In some cases, the doctor may order a thyroid scan to see if the thyroid gland is missing or too small.What is the treatment for congenital hypothyroidism?Congenital hypothyroidism is treated by giving thyroid hormone medication in a pill form called levothyroxine. Many children will require treatment for life. Levothyroxine should be crushed and given once daily, mixed with a small amount of water, formula, or breast milk using a dropper or syringe.Giving your baby his or her thyroid hormone EVERY DAY and having regular checkups with a pediatric endocrinologist will help ensure that your baby will have normal growth and brain development. Your doctor will do periodic thyroid function tests so that the dose of medication can be properly adjusted as your child grows. The hormone in the pill is identical to what is made in the body, and you are just replacing what is missing. In general, side effects occur only if the dose is too high, which the endocrinologist can avoid by checking blood levels on a periodic basis. Article Body Last Updated 6/21/2016 Source Copyright © 2014 American Academy of Pediatrics and Pediatric Endocrine Society"
347,16,"2018-04-19 02:48:19","Glands & Growth",347,"2018-04-19 03:37:19","Failure to Thrive","Failure to Thrive Page Content Article BodyAt each of your child’s checkups, your pediatrician’s office should plot your child’s weight and measurements. In general, you should see a continuous upward trend, although there will be times when she gains very slowly and perhaps some weeks when she actually loses a little weight due to illness. It is not normal for her to stop growing or to lose weight except for the small amount she loses during the first few days of life. If she does lose weight, it is a clear sign either that she is not getting enough to eat or that she is ill. The medical term for this condition is failure to thrive. Although it can happen in older children who are seriously ill or undernourished, it is most common and most dangerous during the active growth period of the first three years. If allowed to continue for a prolonged period, this condition can become serious. Steady weight gain is especially important for infants and toddlers because it means that they are receiving adequate nutrition and care for normal physical, mental, and emotional development. Usually when a child stops growing, it is due to a feeding problem that prevents her from getting as many calories as she needs. As a newborn, she may be too fussy to eat as much as she needs, or, if breastfed, she may not be getting enough milk while nursing. Some children may require more food than their parents are able to provide. These problems must be detected and treated early in order to avoid long-term or permanent damage. Sometimes failure to thrive signals a medical problem. The newborn may have an infection passed on from her mother during pregnancy, or she may have a hormonal difficulty, an allergy, or a digestive problem that prevents nutrients from being absorbed into the body properly. Diseases such as cystic fibrosis, diabetes, or heart disease also can interfere with normal growth. If one of these is present, the child may need a special diet as well as medical treatment. When to Get Help Regularly charting your child’s growth, and comparing her general development with others her age, are the best ways to make sure she is thriving. If she does not gain weight, grow in length, or otherwise develop normally, consult your pediatrician. He will measure and examine your child, ask about her diet and eating patterns, and review her medical history for signs of illness that may be contributing to her failure to thrive. The physician will try to establish exactly when the growth or weight gain stopped, and ask about anything that may have contributed to this. The pediatrician also may watch your child eating or nursing to see how much she consumes and how she responds to food. Sometimes a short period of in-hospital observation may be necessary. If the doctor discovers a physical cause for the decrease in growth rate, he will recommend the appropriate treatment. If there is no physical reason, however, the pediatrician will look for emotional or social problems, particularly within the family. Such disturbances can decrease a child’s appetite or alter her normal food intake and digestion. Once discovered, these difficulties can be treated with individual or family counseling. Last Updated 1/27/2016 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
348,16,"2018-04-19 02:48:19","Glands & Growth",348,"2018-04-19 03:37:27","Growth Hormone Deficiency FAQs","Growth Hormone Deficiency FAQs Page Content​​​What is growth hormone deficiency?Growth hormone deficiency is a rare cause of growth failure in which the child does not make enough growth hormone to grow normally. Growth hormone is one of several hormones made by the pituitary gland, which is located at the base of the brain behind the nose.How frequent is growth hormone deficiency?Estimates vary, but it is rare. The incidence is less than 1 in 3,000 to 1 in 10,000 children.What causes growth hormone deficiency?There are many causes of growth hormone deficiency, most of which are present at birth (called ""congenital"") but may take several years to become apparent or it can develop later (called ""acquired""). Congenital causes include genetic or structural abnormalities of the development of the pituitary gland and surrounding structures, while acquired causes, which are much less common, can include head trauma, infection, tumor, or radiation.What are signs and symptoms of growth hormone deficiency?Children with growth hormone deficiency are usually much shorter than their peers (that is, well below the 3rd percentile line) and over time, they tend to drop farther and farther below the normal range. It is important to note that growth hormone-deficient children are usually not underweight for their height; in many cases, they are on the pudgy side, especially around the stomach.How is growth hormone deficiency diagnosed?Evaluation of a child with short stature and slow growth pattern may include a bone age x-ray (x-ray of the left wrist and hand) and various screening laboratory tests. The diagnosis of growth hormone deficiency cannot be made on a single random growth hormone level, because growth hormone is secreted in pulses. Some pediatric endocrinologists diagnose growth hormone deficiency based on an extremely low level of insulin-like growth factor 1 (IGF-1), which varies much less in the course of the day than growth hormone. IGF- 1 levels are dependent on the amount of growth hormone in the blood but can also be low in normal, young children, so the test must be interpreted carefully.A more accurate but still imperfect way to diagnose growth hormone deficiency is a growth hormone stimulation test. In this test, your child has blood drawn for about 2 to 3 hours after being given medications to increase growth hormone release. If the child does not produce enough growth hormone after this stimulation, then the child is diagnosed with growth hormone deficiency. However, growth hormone stimulation tests can over diagnose growth hormone deficiency. Growth hormone stimulation tests vary and are complicated, so they are usually performed under the guidance of a pediatric endocrinologist. Usually, other tests to check the pituitary or to evaluate the brain (MRI) are performed when treatment is considered.How is growth hormone deficiency treated?The treatment for growth hormone deficiency is administration of recombinant human growth hormone by subcutaneous injection (under the skin) once a day. The pediatric endocrinologist calculates the initial dose based on weight, and then bases the dose on response and puberty. The parent is instructed on how to administer the growth hormone to the child at home, rotating injection sites among the arms, legs, buttocks, and stomach. The length of growth hormone treatment depends on how well the child's height responds to growth hormone injections and how puberty affects the growth. Usually, the child is on growth hormone injections until growth is complete, which is sometimes many years.What are the side effects of growth hormone treatment?In general, there are few children who experience side effects from growth hormone. Side effects that have been described include severe headaches, hip problems, and problems at the injection site. To avoid scarring, you should place the injections at different sites. However, side effects are generally rare. Please read the package insert for a full list of side effects.How is the dose of growth hormone determined?The pediatric endocrinologist calculates the initial dose based on weight and condition being treated. At later visits, the doctor will change the dose for effect and pubertal stage and sometimes based on IGF-1 blood test results. The length of growth hormone treatment depends on how well the child's height responds to growth hormone injections and how puberty affects growth.What is the prognosis for growth hormone deficiency?Growth hormone usually results in an increase in height for growth hormone-deficient individuals, as long as the growth plates have not fused. The reason for the growth hormone deficiency should be understood, and it is important to recheck for growth hormone deficiency when the child is an adult, because some children no longer test as if they are growth hormone deficient when they are fully grown.Additional Information from HealthyChildren.org: Tips for Parents about Growth Hormone InjectionsWhen a Child is Unusually ShortHow to Read a Growth Chart: Percentiles Explained​ Article Body Last Updated 6/21/2016 Source Copyright © 2014 American Academy of Pediatrics and Pediatric Endocrine Society"
349,16,"2018-04-19 02:48:19","Glands & Growth",349,"2018-04-19 03:37:33","Growth Problems in Adopted Children","Growth Problems in Adopted Children Page Content Article BodyOccasionally, children adopted from other countries may have slow growth and developmental delays from inadequate care and nutrition. These children may need special help and more calories than usual to catch up to a level that fits their age. Adoption agencies can put parents in touch with support groups for those in similar situations. Your pediatrician will help with advice and referrals to specialists if they’re required. Last Updated 1/27/2016 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
350,16,"2018-04-19 02:48:19","Glands & Growth",350,"2018-04-19 03:37:40","How to Read a Growth Chart: Percentiles Explained","How to Read a Growth Chart: Percentiles Explained Page Content​When you go to the pediatrician for a well-child check, you'll always review your baby's or child's growth. It's probably the most important piece of data your pediatrician gets. The reason is, it can capture so much about your child's vitality. Growth Chart Downloads:WHO Growth ChartsBirth to 24 Months: Boys Weight-for-length and Head circumference-for-age percentilesBirth to 24 months: Boys Length-for-age percentiles and Weight-for-age percentilesBirth to 24 Months: Girls Weight-for-length and Head circumference-for-age percentilesBirth to 24 months: Girls Length-for-age percentiles and Weight-for-age percentilesCDC Growth ChartsChildren 2 to 20 years: Boys Stature-for-age and Weight-for-age Children 2 to 20 years: Boys BMI-for-ageChildren 2 to 20 years: Girls Stature-for-age and Weight-for-ageChildren 2 to 20 years: Girls BMI-for-age First 3 Years – A Major Growth PeriodIn the first 3 years, we use one growth chart that looks at the head's circumference and the weight and length. It's based on gender and lots of data. We watch for changes in the size of head circumference in infancy because we want to know that the brain is growing. Growth grids have been used since the 1970s, but back in 2000, they were revised to really reflect different cultural and ethnic diversities that exist within our population.Why Percentiles Are Not Like the Grades in SchoolWhat we want from a growth grid is to really map out the ideal growth for children. This isn't like grades in school. When your child comes in at the 10th percentile, it's really no better or worse than coming in at the 90th. What we care about most is the trend at which your baby or child gains weight, height, or head circumference.After age 2, you can use the growth chart to expand between the ages of 2 and 20. In addition to weight and height at that point, we also look at body mass index, that number where we try to capture how children's proportionality is. Are they at risk for overweight or are they too lean?Everything from genetics, to environment, to nutrition, to activity, to health problems really influence how your child grows. Why we review it each time is to talk about threats to your baby's or child's health and ways that you can take great opportunity to make changes.How to Follow the Grid:When you're looking at a growth grid, what you want to focus on is how your child is changing. One static point on the growth grid isn't as relevant as 5 data points over time. You want to know rates at which your baby or child is growing and the rate compared with the grid.As you follow the grid along from infancy into toddlerhood, you'll notice that each time it will rise. Each data point at each set of time will increase. We care about the rate at which your baby or child grows, not the number.Why You Shouldn't Focus on the Number:Parents often come in to the office and say, ""What percent is she at?"" She might be at the 13th percentile; that might be phenomenal based on where she's been previously, or it might be concerning. Don't focus on the number. Have your pediatrician, family doctor, or nurse practitioner help you understand what the trends are for your baby's growth.Parents, pediatricians, and nurses have been using growth charts since the late 1970s to track growth in infants and children. The charts were revised back in 2000 as data for the first charts (from a small study in Ohio) didn't accurately reflect the cultural and ethnic diversity of our communities.The Hallmark of the Well-Child Check:The hallmark of a well-child check is the review of a child's growth. Growth can be a reflection of a child's overall health, nutrition, or tolerance of possible underlying medical conditions. So understanding what your doctor or nurse practitioner says about your child's growth should be a priority.If your doctor doesn't have a computer in the examination room, ask to see the chart on paper or on a computer in the office. It will not only inform you, I suspect it will delight you to see what your child has done since the last time he was seen. The human body really is a fine-tuned machine, and growth is simply astounding if you really stop to think of it. It's true your baby will at least double his weight by 6 months and triple it by about 1 year of age.If You Have Questions:If you have a challenge understanding how your child is growing or how the growth chart is presented, demand clarification. It's OK if you don't understand the presentation of facts on these grids; have confidence to speak up and ask the doctor or nurse practitioner to explain it.Additional Information from HealthyChildren.org:Predicting of Child's Adults Height Your Family Health History & GeneticsWell-Child Care: A Check-Up for Success​ Article Body Author Wendy Sue Swanson, MD, MBE, FAAP Last Updated 9/1/2015 Source Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance (Copyright © 2014 Wendy Sue Swanson)"
351,16,"2018-04-19 02:48:19","Glands & Growth",351,"2018-04-19 03:37:45","Predicting a Child’s Adult Height","Predicting a Child’s Adult Height Page Content Article BodyParents often wonder how tall their toddler or preschooler might be when they grow up. Gradeschoolers and young teens may ask, ""How tall will I be?"" It is a natural question for parents and children, and besides being a little fun to try and predict how tall a child might be, pediatricians also find it helpful to make sure a child is growing as expected. While no one has a crystal ball, there are ways parents and pediatricians can make an educated guess. Read on. How is a Child's Adult Height Predicted? The most accurate method of height prediction comes from using a child's ""bone age,"" determined by an X-ray of the hand, but there are several methods you can use at home to get an idea of how tall your child will eventually become. The most common way to estimate a child's adult height is to base it on the parents' heights. Two Years Times Two MethodDid you know the earliest growth spurt, from baby to toddler, actually accounts for roughly half of a child's adult height? A simple method to predict adult height is to double the child's height at age 2. Girls develop more quickly, so doubling their height at 18 months old can also be used as an estimate of how tall they will be as adults. While this method has been around for a long time, no research exists to demonstrate its accuracy. Mid-Parental MethodA slightly more complex method of predicting your child's height is known as the ""mid-parental method."" Add together the measured heights of the mother and father in inches and divide by 2. For a boy: add 2½ inches For a girl: subtract 2½ inches Note: This is just a very rough estimate of the average height of how tall a child will be when fully grown. You can expect a margin of error of about four inches up or down. The taller the parents, the taller the child is likely to be; similarly, the shorter the parents, the shorter the child.Growth Charts Regular measurements of a child's height, weight and head size and plotting them on a growth chart are a good way to see if your child is growing as expected. Pediatricians use standardized growth charts at each well-child visit. What many people don't realize is that growth charts are also helpful for judging the onset of puberty in an older child. As you may know, puberty is occurring at an earlier age these days. The onset of pubic hair or breast budding in girls can occur normally as early as age six! Growth charts can help pediatricians determine whether your child's early development is in the normal range. Family History & Genetics Height and growth patterns usually run in families. Your child's pediatrician may ask about your own height, since your genetic make-up is the biggest factor in how your children grow. You may also be asked how tall other family members are. Additionally, you may be asked how fast and at what age you grew during your childhood (i.e. your growth pattern). Were you short in grade school but kept growing after all of your friends stopped? Did you go through puberty early or late? These may be important clues for your child's pediatrician.What Else Affects Your Child's Height?While genes play a huge part in predetermining how tall your child will be (e.g. short parents usually have short children) other factors have an impact on how much your child grows. These include: Nutrition: A child who is overweight is often taller than classmates, although that does not necessarily mean that he will be taller as an adult. Children who are very underweight might be shorter than expected for age. Hormones: Hormone imbalances, such as low thyroid or growth hormone levels, lead to slower than expected growth and can result in children who are either shorter or taller than would be expected if not diagnosed and treated. Review red flags to help you tell if your child is growing normally and will reach his predicted height or if he might have a growth hormone problem. Medications: Some medications, particularly chronic use of corticosteroids (like prednisone), can slow growth. Health conditions: Children with some chronic illnesses, such as severe arthritis, untreated celiac disease, or cancer may be shorter than expected. Genetic conditions: Children with some genetic conditions can cause either short or tall stature. For example, those with Down Syndrome, Noonan Syndrome, or Turner Syndrome tend to be shorter than other family members, while Marfan Syndrome can cause someone to be taller.  Additionally, exercise, pollution, sleep patterns, climate, fitness, diet, and psychological well-being can also impact growth.If You Have Concerns about Your Child's Height:  If you are concerned about your child's height or think that your child may be growing too fast or too slowly, talk to your pediatrician. If needed, your pediatrician can order further tests. A simple x-ray of the hand and wrist may show how much growth your child has left. Lab tests can also help find the cause of growth problems and how to treat them. You may also be referred to a pediatric endocrinologist, pediatric geneticist, or other pediatric specialist for further evaluation and treatment. Don't delay!Remember, once your child finishes puberty, growth stops. A short teenager has little or no time to catch up on growth, while a younger child still has time to be treated and grow taller. Last Updated 1/27/2016 Source Section on Genetics and Birth Defects (Copyright © 2015 American Academy of Pediatrics)"
352,16,"2018-04-19 02:48:19","Glands & Growth",352,"2018-04-19 03:37:49","Tips for Parents about Growth Hormone Injections","Tips for Parents about Growth Hormone Injections Page Content Article BodyWhat is growth hormone treatment?Growth hormone is a protein hormone that is usually made by the pituitary gland to help your child grow. After training, you will be giving your child an injection of recombinant growth hormone (rGH) every day, once per day. Recombinant means that this growth hormone shot is created in the laboratory to be identical to human growth hormone. Growth hormone has been available for treatment since the 1950s. However, rGH is safer than the original preparations, because it does not contain human or animal tissue.What are the side effects of growth hormone treatment?In general, there are few children who experience side effects due to growth hormone. Side effects that have been described include headache and problems at the injection site. To avoid scarring, you should place the injections at different sites such as arms, legs, belly and buttocks. However, side effects are generally rare. Please read the package insert for a full list of side effects.How is the dose of growth hormone determined?The pediatric endocrinologist calculates the initial dose based upon weight and condition being treated. At later visits, the doctor will increase the dose for effect and pubertal stage.The length of growth hormone treatment depends on how well the child's height responds to growth hormone injections and how puberty affects this or her growth.Additional Information: Delayed Puberty in Boys: Information for Parents Delayed Puberty in Girls: Information for Parents  Last Updated 10/20/2015 Source Copyright © 2014 American Academy of Pediatrics and Pediatric Endocrine Society"
353,16,"2018-04-19 02:48:19","Glands & Growth",353,"2018-04-19 03:37:54","When a Child is Abnormally Tall","When a Child is Abnormally Tall Page Content​​​ Article BodySome children may be abnormally tall for their age from an early, rapid development of puberty or from an excess production of the growth hormone by the pituitary gland. These and other more rare conditions can stimulate growth, particularly of the jaw and the long bones of the arms and legs. Most of these conditions can be treated. Early Growth Spurts & Precocious Puberty Generally, growth spurts for girls start about two years earlier than growth spurts for boys. Children with precocious puberty experience early growth spurts because of the abnormally early rise in sex hormone levels in their bodies. Initially this causes these children to grow taller than other kids their age, but their skeletons mature more rapidly. Often this causes them to stop growing at an early age, and they end up being average or below average height as adults. Too Much Growth Hormone (Hyperpituitarism)Two conditions arise from excessive amounts of growth hormone in the body: acromegaly and gigantism. Acromegaly is a condition in adults that is caused by an increased secretion of the growth hormone after normal growth has stopped. It is very rare. Because adults cannot grow taller, the excess growth hormone in acromegaly causes an adult's bones to thicken and other structures and organs to grow larger. Gigantism occurs when there is an excessive secretion of growth hormone in children before their normal growth has stopped. This results in overgrowth of the long bones. In addition to vertical growth in height, there is also growth in muscle and organs. The result is a person who is very tall, with a large jaw, large face, large skull, and very large hands and feet. If You Have Concerns about Your Child's HeightIf you are concerned about your child's height or think that your child may be growing too fast, talk to your pediatrician. If needed, your pediatrician can order further tests. A simple x-ray of the hand and wrist may show how much growth your child has left. Lab tests can also help find the cause of growth problems and how to treat them. You may also be referred to a pediatric endocrinologist, pediatric geneticist, or other pediatric specialist for further evaluation and treatment.Additional InformationPredicting of Child's Adults HeightHow to Read a Growth Chart: Percentiles ExplainedYour Family Health History & GeneticsWhat is a Pediatric Endocrinologist? Last Updated 6/21/2016 Source Section on Endocrinology (Copyright © 2014 American Academy of Pediatrics)"
354,16,"2018-04-19 02:48:19","Glands & Growth",354,"2018-04-19 03:38:06","When a Child is Unusually Short","When a Child is Unusually Short Page Content​​​ Article BodyWhat is short stature?The term ""short stature"" refers to any child who has a height well below the average for age and sex. The term is most commonly applied to children whose height, when plotted on a growth curve in the pediatrician's office, is below the line marking the third or the fifth percentile. What is a growth chart?The growth chart uses lines to display an average growth path for a child of a certain age, sex, and height. Each line indicates a certain percentage of the population that would be that particular height at a particular age. A boy with a height that is plotted on the 25th percentile line, for example, indicates that approximately 25 out of 100 boys his age are shorter than him.Children often do not follow these lines exactly, but most of the time their growth over time is roughly parallel to these lines. A child that has a height plot that is below the 3% line is considered to have short stature compared with the general population.What kind of growth pattern is abnormal?Growth specialists take many things into account when assessing your child's growth. For example, the heights of a child's parents are an important indicator of how tall a child is likely to be when fully grown. A child born to parents who are below average height will most likely grow to have an adult height below average as well. The rate of growth, referred to as the growth velocity, is also important. Children who are not growing at the same rate as their friends will slowly drop further down on the growth curve as they age; for example, crossing from the 25th to the fifth percentile line. Such crossing of percentile lines on the growth curve is often a warning sign of an underlying medical problem affecting growth.What causes poor growth or short stature?Although slower than normal growth may be a sign of a significant health problem, most children who have short stature have no medical condition, are healthy, and grow at a normal rate. Causes of short stature not associated with recognized diseases include:Familial short stature (one or both parents are short, but the child's rate of growth is normal)Constitutional delay in growth and puberty (the child is short during most of childhood but will have late puberty and end up in the normal height range as an adult).Idiopathic short stature (no identifiable cause, but the child is healthy) Short stature may occasionally be a sign that a child does have a serious health problem, but there are usually clear symptoms suggesting something is not right. Medical conditions affecting growth may include:Chronic medical conditions affecting nearly any major organ, including heart disease, asthma, celiac disease, inflammatory bowel disease, kidney disease, anemia, and bone disordersHormone deficiencies, including hypothyroidism, growth hormone deficiency, diabetes, and Cushing disease, in which the body makes too much hydrocortisone.Genetic conditions including Down syndrome, Turner syndrome, Russell-Silver syndrome, Noonan syndrome and rare bone problems, such as achondroplasia. There are standardized growth charts available for some syndromes such as Down syndrome, Noonan syndrome, Turner syndrome, Russell-Silver syndrome and others Poor nutrition.Babies with a history of being born small (small for gestational age or with a history of intrauterine growth delays).Medications, such as those used to treat attention deficit hyperactivity disorder (ADHD) and inhaled steroids used for asthma.What tests might be used to assess my child?The best ""test"" is to monitor the child's growth over time using the growth chart. Six months is a typical time frame for older children, and if the rate of growth is clearly normal, no additional testing may be needed. In addition, your doctor may check your child's bone age (x-ray of left hand/wrist), which may help in a child older than 7 years predict how tall the child will be as an adult. Blood tests are rarely helpful in a mildly short but healthy child who has is growing at a normal growth rate; a child growing along the fifth percentile, for example.However, if the child is below the third percentile or is growing more slowly than normal, doctors will usually do some tests to look for signs of one or more of the medical conditions described above.Additional Information:Predicting of Child's Adults HeightHow to Read a Growth Chart: Percentiles ExplainedYour Family Health History & GeneticsWhat is a Pediatric Endocrinologist? Last Updated 6/21/2016 Source Copyright © 2014 American Academy of Pediatrics and Pediatric Endocrine Society"
355,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",355,"2018-04-19 03:38:10","Car Sickness","Car Sickness Page Content Article BodyMy child gets sick in the car quite often. How can we keep this from happening? Motion sickness occurs when the brain receives conflicting signals from the motion-sensing parts of the body: the inner ears, the eyes, and nerves in the extremities. Under usual circumstances, all three areas respond to any motion. When the signals they receive and send are inconsistent—for example, if you watch rapid motion on a movie screen, your eyes sense the motion, but your inner ear and joints do not—the brain receives conflicting signals and activates a response that can make you sick. The same thing can happen when a child is sitting so low in the backseat of a car that she cannot see outside. Her inner ear senses the motion, but her eyes and joints do not. Signs and symptoms Motion sickness usually starts with a vague feeling of stomach upset (queasiness), a cold sweat, fatigue, and loss of appetite. This usually progresses to vomiting. A young child may not be able to describe queasiness, but will demonstrate it by becoming pale and restless, yawning, and crying. Later she will lose interest in food (even her favorite ones), and even vomit. This response can be affected by previous car trips that made her sick, but it usually improves over time. Causes We do not know why motion sickness happens more often in some children than others. Since many of these children years later experience occasional headaches, there is a belief that motion sickness may be an early form of migraine. Motion sickness occurs most often on a first boat or plane ride, or when the motion is very intense, such as that caused by rough water or turbulent air. Stress and excitement also can start this problem or make it worse. What you can do If your child starts to develop the symptoms of motion sickness, the best approach is to stop the activity that is causing the problem. If it occurs in the car, stop as soon as safely possible and let her get out and walk around. If you are on a long car trip, you may have to make frequent short stops, but it will be worth it. If this condition develops on a swing or merry-go-round, stop the motion promptly and get your child off the equipment. Since “car sickness” is the most common form of motion sickness in children, many preventive measures have been developed. In addition to frequent stops, try the following. If she has not eaten for three hours, give your child a light snack before the trip—which also helps on a boat or plane. This relieves hunger pangs, which seem to add to the symptoms. Try to focus her attention away from the queasy feeling. Listen to the radio, sing, or talk.  Have her look at things outside the car, not at books or games. If none of the above works, stop the car, remove her from her car seat, and have her lie on her back for a few minutes with her eyes closed. A cool cloth on the forehead also tends to lessen the symptoms. Medications If you are going on a trip and your child has had motion sickness before, you might want to give her medication ahead of time to prevent problems. Some of these medications are available without a prescription, but ask your pediatrician before using them. Although they can help, they often produce side effects, such as drowsiness (which means that when you get to your destination your child might be too tired to enjoy it), dry mouth and nose, or blurred vision. When to call the pediatrician If your child has symptoms of motion sickness at times when she is not involved with a movement activity—particularly if she also has a headache; difficulty hearing, seeing, walking, or talking; or if she stares off into space—tell your pediatrician about it. These may be symptoms of problems other than motion sickness. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
356,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",356,"2018-04-19 03:38:14","Children with Epilepsy at School","Children with Epilepsy at School Page Content Article BodyChildren of all ages have epilepsy and most attend school every day. As a parent or caregiver, you play a key role in providing your child's teachers and other school staff with the information they need to create a safe and supportive learning environment where your child can thrive.Sharing Information with Your Child's School Work with your school to make sure teachers and other school staff know what to do when a seizure occurs. It is important that every student with seizures has a Seizure Action Plan. This plan should be provided to all administrative staff and teachers at the school. Many schools have a form for students with special health care needs, sometimes called the ""Individual Health Plan,"" which can used as the Seizure Action Plan. What's included in a Seizure Action Plan? The seizure action plan should be reviewed and signed by your child's doctor and should include the following information:Detailed information about your child's epilepsy.What to do if your child has a seizure at school or on the bus.A list of anti-seizure medications that your child currently is taking, including how and when the medications are given, and any side effects. Special instructions for the use of rescue medications, used in the case of an emergency, should also be included. If your child has a vagus nerve stimulator (VNS), then instructions on how to use the VNS magnet should also be included.A clear definition of what constitutes an emergency for your child, and what the school should do if one occurs.What else is important to do if your child is using a Seizure Action Plan? Review and update the plan regularly. It is especially important to update when the medications change or dosages are increased or decreased.Make sure your child can take medicine at school. This might mean talking to the school nurse or another school official about how to give the medication. Ensure that the Seizure Action Plan information is also available during school activities that may occur outside of school hours or off school property, such as bus rides, field trips, or sporting events.Educating Your Child's Classmates It can be frightening for students to witness a seizure. Educating your child's classmates early on about proper seizure first aid and epilepsy can reduce stigma, decrease fear, and improve the overall acceptance of your child. Start by having a conversation with your child about his or her seizures. Explore when, where, and how to tell others about his or her epilepsy. Every situation and every child will be different, so doing some role playing and discussing how people might react can be helpful. Here are some suggestions about how to inform others:Consider reaching out to school staff to explore educating your child's classmates. Keep your child involved in the education process, too. There are many educational programs and tools available to help teachers create a basic epilepsy program. Be a special guest/presenter for the day. Use the curriculum available here​. Visit the Epilepsy Foundation's Public Awareness page for information and ideas on talking about epilepsy, as well as a curriculum for training middle school and high school students.Reach out to a local Epilepsy Foundation. Every Foundation affiliate has turnkey educational programs to train students. Foundation staff can assist in the training, too.Getting to Know Your Child's School and the StaffTake the opportunity to connect and build partnerships with school staff, volunteers, and other parents. Here are some ideas on how to form those relationships: Talk with your child's teachers and other school staff about epilepsy and explain what happens when your child has a seizure.Join and volunteer to help within parent-teacher organizations.Volunteer to assist at school functions, class parties, etc.Become familiar with the school policies and the school handbook.Organize meetings with teachers, nursing staff, lunchroom staff, bus drivers, etc.Like all children, those with epilepsy also need to become familiar with each person in the school that they will interact with, such as the school nurse, principal, etc. This is especially important as they grow older and begin taking more responsibility for their health care needs. Preparing for Seizure Emergencies at SchoolEmergencies can happen when your child is in school, and it is important to make sure everyone is prepared. Here's how to prepare your child and the school for a seizure emergency: Research school and district regulations.Talk with the school nurse about how emergencies can best be handled.Develop an emergency plan as part of your child's seizure action plan.Keep contact information current.Share the plan with all school staff and volunteers (e.g., teachers, recess supervisors, physical education teachers, library staff, lunchroom supervisors, field trip chaperones, or after school activity staff.)Knowing Your Child's RightsMost schools must follow the Americans with Disabilities Act (ADA) and provide ""reasonable accommodations"" if your child has special needs. Other laws, like Section 504 of the Rehabilitation Act of 1973 and the Individuals with Disabilities in Education Act (IDEA), might also apply if your child has special physical or learning challenges. Be on the lookout for learning problems or challenging behaviors in your child. Know that you can seek help from the school counselor or request a psychoeducational evaluation from the school psychologist if you feel your child is not performing well.Avoiding Bullying and Discrimination All children can experience bullying and discrimination in some form. However, those with epilepsy can be an easy target. If you suspect your child is the victim of bullying or discrimination, contact the school to discuss it further. Here are some great resources: Bullying Resource Center Bullying.org Stopbullying.gov Epilepsy Foundation - Legal IssuesHelping Your Child Thrive Remember that your child is more like other students than different. One of your roles as a parent is to help them thrive in their school setting with confidence and a belief that they can reach any goal they set for themselves. This is best done by educating and preparing the school to meet their needs and building your child's or youth's capacity to eventually manage their needs when you are not around.Additional Information from HealthyChildren.org Seizures and Epilepsy in Children Epilepsy in Children: Diagnosis & Treatment How to Support a Child with Epilepsy: Information for Parents Your Right to Special ServicesAdditional Information from the Epilepsy Foundation Training for Educators Your Child at School and Child Care Tips for Seizure Observation and Recording (PDF) Seizure Observation Form (PDF) Last Updated 11/9/2015 Source Developed with funding from the Health Resources and Services Administration, Maternal and Child Health Bureau under Cooperative Agreement Number U23MC08582 for Project Access and Cooperative Agreement Number U23MC26252."
357,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",357,"2018-04-19 03:38:18","Dizziness and Fainting Spells","Dizziness and Fainting Spells Page Content Article BodySyncope (Dizziness and Fainting Spells) A temporary decrease in blood flow to the brain results in unconsciousness, or fainting. Many disorders, some of them serious, can cause this. “In adolescents,” says pediatric neurologist Dr. Patricia Crumrine of the University of Pittsburgh Medical Center, “fainting usually turns out to be due to vasovagal syncope.” Your pediatrician may also refer to it as neurally mediated syncope. The condition is not serious, although a child can incur head injuries and lacerations from collapsing. Syncope can be set off by pain, fatigue, heat, exercise, stress—even intense emotions, like the shock of hearing some distressing news or watching a scary scene in a movie. In response, the heart contracts more forcefully than usual. The nervous system, sensing this, overreacts. It slows down the pumping action, inducing a sudden drop in blood pressure. At the same time, it narrows major blood vessels, including those that carry blood to the brain. Typically, young victims regain consciousness after a few minutes, with no lingering effects, and have full recall.  Symptoms of Syncope Sudden light-headedness, followed by loss of consciousness and collapse. How Syncope is Diagnosed Physical examination and thorough medical history Tilt-table test Vasovagal syncope runs through many family trees. “When we take the patient’s family history,” says Dr. Crumrine, “we often find that a close relative experienced similar symptoms at around the same age.” A diagnosis can frequently be reached just on the basis of the history and possibly a tilt-table test. This simple, noninvasive procedure entails strapping a young patient to a mechanical table, then tilting it up to a near-standing position. She remains at this angle for ten to fifteen minutes. Fainting brought on by a rapid drop in blood pressure and heart rate is considered a positive result for vasovagal syncope. Rest assured that once the table is lowered, the patient’s heartbeat and circulation return to normal, and she regains consciousness. The physician may order a variety of additional tests to rule out other conditions, such as seizures (epilepsy) and cardiac disorders.  How Syncope is Treated Dietary measures: Teenagers who are prone to fainting tend not to eat the recommended daily allowance of two thousand to three thousand milligrams of salt. While a diet high in sodium can eventually lead to hypertension, too little salt isn’t healthy either, for two of the mineral’s functions are to regulate blood pressure and retain fluid in the circulation. Children often do not take in enough fluid. This, too, contributes to vasovagal syncope. Your youngster should be drinking the equivalent of at least eight cups of water and other fluids per day. Drug therapy: If medication is used, one of three drugs is typically called on to control the symptoms of vasovagal syncope. Fluorocortisone, a mineralo corticoid steroid, compels the kidneys to recirculate dietary salt instead of excrete it in the urine. Potassium is sacrificed instead; accordingly, a potassium supplement is often added when young patients begin the medication. Atenolol works by way of an entirely different mechanism. The beta-blocker decelerates the heartbeat and prevents the powerful contractions that switch on the fainting reflex. Disopyramide, too, decreases the strength of the contraction, but it belongs to two different groups of agents: antiarrhythmics and anticholinergics.  Helping Teenagers Help Themselves The measures below can help teens who are prone to fainting reduce the frequency of future episodes: Learn to recognize the early signs of a faint. A full swoon can be prevented by placing the head between the knees or by lying down. Minimize the amount of time spent in warm environments, such as showers and baths, and a hot midday sun. Saunas, hot tubs and Jacuzzis are to be avoided. When you are standing for long periods of time, shift your weight and flex your leg muscles, to keep the circulation moving. Even subtle movements, like bending forward from the waist, aid blood flow to the brain. When sitting for extended periods of time, sit in a low chair, lean forward with your hands on your knees or bring your knees up to your chest. Use pillows to elevate the head of the bed slightly. Avoid alcohol, which causes veins to widen, further reducing blood pressure.  What to Do if a Youngster Faints  If you can, try to catch him before he hits the floor. Gently lay him down on his back. If he has food in his mouth, lay him on his side with his face turned to the floor. Do not attempt to rouse the youngster with ammonia or ammonia capsules, or by dousing him with cold water or slapping his cheeks. He should come to on his own within several minutes. Inform your pediatrician.  Other Causes of Fainting in Teens Two other common causes of dizziness and fainting in young people are hyperventilation  and orthostatic hypotension. “Orthostatic” means “caused by standing erect”; “hypotension,” “low blood pressure.” Adolescents with this condition may feel dizzy and weak if they stand up too quickly from a prone position. The drop in blood pressure is related to pubertal growth causing a rapidly rising center of gravity and expanding blood volume. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
358,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",358,"2018-04-19 03:38:22","Epilepsy in Children: Diagnosis & Treatment","Epilepsy in Children: Diagnosis & Treatment Page ContentEpilepsy is the most common childhood brain disorder in the United States – nearly 3 million Americans have this condition (450,000 of which are under age 17). About two-thirds of all children with epilepsy outgrow their seizures by the time they are teenagers. However, it is important for parents to help their child maintain a healthy lifestyle and ensure regular medical visits.About Epilepsy & SeizuresEpilepsy is a brain disorder where a person has recurring seizures. The seizures are triggered by changes in the electrical and chemical activity in the brain. Seizures can be caused by anything that injures the brain, including head injuries, infections, poisoning or even brain development problems prior to birth. Often a cause for the seizures and epilepsy cannot be found.There are many different types of seizures. Some are very short, lasting only a few seconds, while others can last a few minutes. The type of seizure a person has depends on where the seizure occurs in the brain and how much of the brain is involved.A doctor will typically diagnose a child with epilepsy (also called a seizure disorder) if:​The child has one or more seizuresThe doctor thinks the child is likely to have a seizure againThe seizure was not directly caused by another medical condition, like diabetes or a severe infectionEpilepsy affects every child differently depending on:Age Types of seizureResponse to treatmentHaving other health issues, etc. Some people with seizures can easily control them with medication and eventually outgrow them all together. Others may have difficulties throughout their lives. Improvements in epilepsy treatment in recent years have made the condition more manageable. Many new anti-seizure medications are available and more are being tested. Alternative treatments are also available for children who continue to have seizures while on medication. How is Epilepsy Diagnosed?Making a diagnosis involves identifying a condition or disease based on signs and symptoms. An epilepsy diagnosis is generally made when seizures occur more than once without an identifiable reason, such as fever or injury. Any child without a known diagnosis of epilepsy who experiences an unprovoked seizure needs immediate emergency medical attention and then have follow-up with her primary care pediatrician soon thereafter. If seizures reoccur, children should see a pediatric neurologist, a specialist who manages seizures and epilepsy. While every child's diagnostic process will vary, the major steps in the process typically include: Detailed medical history: May include questions regarding the mother's pregnancy and delivery, any relatives with epilepsy, and if the child had a high fever, serious head injury and/or periods of staring, inattention or breath-holding. Detailed account of the seizure: The person(s) who were present at the time of the child's seizure should communicate with the doctor. Physical examination: Assessment of cardiac, neurological, and mental status. Blood test: To identify potential causes and or other significant illnesses. Computerized Axial Tomography (CAT) or CT Scan: Can be used to determine whether a seizure was caused by an acute neurological lesion or illness. Electroencephalogram (EEG): Can be used to assess the risk of seizure recurrence and may help determine seizure type and epilepsy syndrome. Magnetic Resonance Image (MRI): Preferred brain picture when evaluating children with new onset seizures or seizures that may have started in a particular part of the brain.After the exam, tests, and a period of observation, a doctor determines whether a child has epilepsy.If a child is diagnosed with epilepsy:After a diagnosis of epilepsy is made, it is important for parents to work with the doctor to classify what type(s) of seizures the child is having, and what type of epilepsy the child has, and discuss treatment options. As seizures do not often happen in the doctor's office, parents and caregivers must observe and track any unusual behavior and report it to their child's doctor. These resources from the Epilepsy Foundation were designed to assist parents in record keeping: Tips for Seizure Observation & Recording Child Seizure Record Form Seizure Description Form Seizure Tracking AppsDoctors will assess whether a child's symptoms and characteristics (age, seizure frequency, family history, etc.) fit a certain kind of epilepsy syndrome or pattern. Classifying the epilepsy syndromes depends on the type of seizure, test results, the child's behavior during the seizure, and the expectations for a child's response to treatment. Click here for a list of additional questions to ask the doctor to help take care of a child's epilepsy.How is Epilepsy Treated?Treatment for epilepsy usually begins with medication. However, it is important to remember that epilepsy is a complex condition and every child is different. Not every child responds to treatment in the same way, so there is no one ""right treatment.""Seizure-prevention drugsThere are many seizure-prevention drugs, called anti-epilepsy drugs (AEDs) or anticonvulsant drugs, on the market and new ones in development. However, it sometimes takes a while to find the one that works best for each child. These drugs do not change the brain's underlying susceptibility to produce seizures. They only treat the symptoms of epilepsy by reducing the frequency of seizures. The medication will not work properly until it reaches a certain level in the body, and that level has to be maintained. For this reason, it is especially important to follow the doctor's specific medication instructions. If medication does not work, other options include:Brain surgeryMedical devices to prevent and control seizuresDietary therapies (e.g. ketogenic diet, modified Atkins diet, low glycemic index treatment) How long a child needs to take medication for epilepsy:If a child does not have a seizure for a few years while taking medication, it may be possible to stop taking it. This is different for every child. A child should never stop taking medication unless it is recommended and closely supervised by a doctor.Risks for other medical issues:Epilepsy can increase a child's chance of having a mood or learning disorder. Headaches, ulcers, and other physical conditions are also common. It is important for parents to know about possible ""co-morbidities"" and talk to their child's doctor about any concerns.Additional Information & Resources: Types of Seizures Seizures and Epilepsy in Children How to Support a Child with Epilepsy: Information for Parents​ What is a Child Neurologist?​Epilepsy Foundation​ Article Body Last Updated 8/1/2016 Source Developed with funding from the Health Resources and Services Administration, Maternal and Child Health Bureau under grant U23MC08582 for Project Access. (Copyright © 2010 Epilepsy Foundation of America, Inc)"
359,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",359,"2018-04-19 03:38:28","Febrile Seizures","Febrile Seizures Page Content Article Body Febrile seizures (seizures caused by  fever) occur in 3 or 4 out of every 100 children between six months and five years of age, but most often around twelve to eighteen months old. Children younger than one year at the time of their first simple febrile seizure have approximately a 50 percent chance of having another, while children over one year of age when they have their first seizure have about a 30 percent chance of having a second one. Nevertheless, only a very small number of children who have febrile seizures will go on to develop epilepsy.​What is a febrile seizure?A febrile seizure usually happens during the first few hours of a fever. The child may look strange for a few moments, then stiffen, twitch, and roll his eyes. He will be unresponsive for a short time, his breathing will be disturbed, and his skin may appear a little darker than usual. After the seizure, the child quickly returns to normal. Seizures usually last less than 1 minute but, although uncommon, can last for up to 15 minutes.Febrile seizures rarely happen more than once within a 24-hour period. Other kinds of seizures (ones that are not caused by fever) last longer, can affect only one part of the body, and may occur repeatedly.What do I do if my child has a febrile seizure?If your child has a febrile seizure, act immediately to prevent injury.  Place her on the floor or bed away from any hard or sharp objects. Turn her head to the side so that any saliva or vomit can drain from her mouth. Do not put anything into her mouth; she will not swallow her tongue. Call your child's doctor. If the seizure does not stop after 5 minutes, call 911 or your local emergency number.Will my child have more seizures?Febrile seizures tend to run in families. The risk of having seizures with other episodes of fever depends on the age of your child. Children younger than 1 year of age at the time of their first seizure have about a 50% chance of having another febrile seizure. Children older than 1 year of age at the time of their first seizure have only a 30% chance of having a second febrile seizure.​Are febrile seizures dangerous?While febrile seizures may be very scary, they are harmless to the child. Febrile seizures do not cause brain damage, nervous system problems, paralysis, intellectual disability, or death.How are febrile seizures treated?If your child has a febrile seizure, call your child's doctor right away. He or she will want to examine your child in order to determine the cause of your child's fever. It is more important to determine and treat the cause of the fever rather than the seizure. A spinal tap may be done to be sure your child does not have a serious infection like meningitis, especially if your child is younger than 1 year of age.In general, doctors do not recommend treatment of a simple febrile seizure with preventive medicines. However, this should be discussed with your child's doctor. In cases of prolonged or repeated seizures, the recommendation may be different.Medicines like acetaminophen and ibuprofen can help lower a fever, but they do not prevent febrile seizures. Your child's doctor will talk with you about the best ways to take care of your child's fever.If your child has had a febrile seizure, do not fear the worst. These types of seizures are not dangerous to your child and do not cause long-term health problems. If you have concerns about this issue or anything related to your child's health, talk with your child's doctor.​ Last Updated 11/30/2017 Source Febrile Seizures (Copyright © 1999 American Academy of Pediatrics, Updated 1/2012)"
360,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",360,"2018-04-19 03:38:32",Headaches,"Headaches Page Content Article BodyAt one time or another, almost all children complain of a headache. In fact, the three most common recurring pain symptoms that pediatricians see are abdominal pain, chest pain, and headaches. While a sudden severe headache may suggest a serious problem within the head or central nervous system and require prompt evaluation, headaches are most often a symptom of other medical or emotional problems. Your child may be feeling stress and tension. Or she may have a cold, the flu, or strep throat. Sometimes fevers and headaches occur at the same time, so if your child complains of head pain, check her temperature. Some children experience a recurrent headache called migraine, which can begin in childhood. Unlike headaches caused by tension, these are often accompanied by other symptoms. Children may have a premonition that they will occur. Often, the headache occurs along with nausea, vomiting, or visual disturbances. The head pain itself is typically throbbing or stabbing and may affect one or both sides of the front part of the head. There may also be other unpleasant sensations in the head, including burning, tingling, aching, or squeezing. The child may prefer a darkened room.  Migraines tend to run in families. Migraine pain is cause by chemicals produced in the brain that alter blood vessels in the brain. (By comparison, stress headaches are characterized by a contraction of the muscles at the back of the head.) The head pain typically lasts for several hours or even overnight. In diagnosing your child's headache you pediatrician will look for an underlying disease or condition. For most types of headaches, rest and some pain medication like acetaminophen on nonsteroidal anti-inflammatory drugs may be all that is necessary, along with treatment of the primary disorder. Depending on the type of headache, your doctor might also recommend prescription drugs or stress-management techniques. If migraines occur more than two to three times a month-and particularly if they interfere with attending or functioning well in school-your doctor may prescribe medication as a preventive measure. A number of oral and nasal drugs that can control the attack are now available for older children. The doctor may also suggest some counseling to explore whether emotional factors may be contributing to the headaches. Headaches should not be allowed to control home or school activities. Last Updated 11/21/2015 Source Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics)"
361,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",361,"2018-04-19 03:38:37","Headaches: When to Call the Pediatrician","Headaches: When to Call the Pediatrician Page Content Article BodyMild to moderate pain from tension headaches is one of the most prevalent medical complaints of the teen years. A tension headache typically comes on over the course of the day, producing a viselike pressure on both sides of the scalp and down the neck. “What happens is that the scalp muscles tighten around the skull,” explains Dr. John Kulig of Boston’s New England Medical Center, “usually in response to stress.” Migraine headaches, seen in 10 percent of adolescents, particularly girls, are characterized as attacks—that’s how severe they are. When the pounding pain on one side of the skull is preceded by a visual disturbance, a person is said to have a migraine with aura. “The person will see bright, flashing lights, pinwheels or zigzag patterns,” says ophthalmologist Harold Koller, who adds that parents often mistakenly attribute the optical illusions and headaches to eye strain. An aura may subside within minutes or continue for hours, while the pain lasts for several hours, on average. A migraine without aura strikes suddenly and persists for anywhere from three hours to several days. Migraines may occur frequently, as often as several times a week, or rarely, with years between episodes. There are many possible causes or triggers of migraines, including stress, various foods and the constriction of blood vessels in the head and neck, which reduce circulation to the brain. In 2000, researchers at the National Institutes of Health discovered another cause: a malfunction in the back of the brain. Apparently, a trigger stirs abnormally excitable brain cells into firing off tiny impulses. The electrical charges ripple throughout the brain and brain stem, stimulating pain receptors along the way. Symptoms of Headaches May Include: Tension Headaches Constant, dull ache on both sides of the forehead Sensation of tightness in the head, radiating down the neck Migrane Headaches Migraine with aura: Visual disturbance called an aura Throbbing, incapacitating pain that starts on one side of the head and occasionally envelops the other side Drowsiness Migraine without aura: Throbbing, incapacitating pain on one side of the head Mental dullness Moodiness Fatigue Fluid retention Sensitivity to light Diarrhea Nausea and vomiting Drowsiness Causes of Headaches Headaches often accompany illnesses such as viruses, strep throat, allergies, sinus infections and urinary-tract infections. Other common causes include: Extreme hunger or thirst Not getting enough sleep Specific foods and beverages, such as chocolate, hard and aged cheeses, pizza, yogurt, nuts, lima beans, processed meats, some fruits and fruit juices Food additives (monosodium glutamate, nitrates, nitrites) Certain nonprescription dietary supplements and medications, and prescription drugs (birth-control pills, tetracycline, excessive doses of vitamin A) Food products and beverages containing caffeine (sodas, coffee, chocolate) Alcohol, cocaine and other illicit substances Eye strain, including sun glare Fatigue Tooth infections or abscesses Hormonal changes during a girl’s menstrual cycle Changes in the weather Emotional stress, depression, anxiety, intense anger, extreme excitement Noisy, hot, stuffy environments Flickering or glaring lights Strong aromas Clenching or grinding teeth Physical exertion Head injury How Headaches are Diagnosed Physical examination and thorough medical history More involved and/or invasive procedures such as CT scan, MRI scan, lumbar puncture, would be performed only if a serious condition was suspected How Headaches are Treated Headaches respond best to treatment when they’re still in their early stages. If your teen has a tension headache, encourage her to lie down and relax, with her head elevated slightly. A hot bath or shower can help to ease the pain, as can placing a warm or cold compress on the forehead and/or neck. For migraine sufferers, you want to minimize sensory stimulation: Turn off the lights in the room, close the curtains, ask family members to keep the noise level down and so on. A cold pack helps here too, but do not apply heat—that will only make the pain worse. Drug therapy: Tension headaches and migraines frequently respond well to a single dose of the over-the-counter analgesics acetaminophen or ibuprofen. According to the American Council on Headache Education, acetaminophen gets down to business more quickly, but ibuprofen appears to provide superior pain relief. If the symptoms recur, the next step might be a prescription for one of the “triptans”: sumatriptan, zolmitriptan, naratriptan, rizatriptan. This family of drugs puts a halt to two in three migraines by blocking the action of the neurotransmitter serotonin. And because triptans are nonsedating, teens may be able to return to the classroom or to other activities more quickly, without having to sleep off the migraine. We never want to overmedicate, however, for fear of inducing rebound headaches. The phenomenon was discovered in the 1980s. Apparently, taking analgesics every day or every other day interferes with the brain’s own ability to battle pain. The net effect is that over time the teenager begins to experience more headaches between doses. What’s more, the medicines that once brought relief no longer seem as effective. Put your finger on the trigger: Your pediatrician may suggest keeping a “headache diary” to help pinpoint the cause of your teen’s headaches. In it, she writes down the following information: when the headache occurred how long it lasted what she was doing when the headache came on foods eaten that day amount of sleep the night before any observations on what seems to make the headaches better or worse Identifying and eliminating the precipitating factor of migraines—be it a certain food, a medication, a situation—can significantly reduce their occurrence. Some triggers, though, can’t be avoided, like the stress of school. When researchers at the Palm Beach Headache Center in Palm Beach, Florida, studied nineteen hundred migraine sufferers aged twelve to seventeen, they discovered a fascinating (though not entirely surprising) pattern: Of the seven days of the week, the rate of migraines was the lowest (9 percent) on Saturdays and peaked (20 percent) on Mondays. Relaxation exercises, taught by your pediatrician or a mental health professional, can help kids to handle stress with greater resilience. Another mind body technique, biofeedback, has proved useful in reducing both the frequency and the duration of migraine headaches. Psychotherapy, too, may play a part in treating migraines. Helping Teenagers Help Themselves The tips below can help youngsters to avoid headaches: Get the proper amount of sleep. Eat regular meals, if possible. If not, snack frequently. Exercise regularly. Be aware of any pattern to your headaches that might help you to identify headache triggers. Teen Tip: Teenagers plagued by three or more migraines a month may be candidates for preventive (prophylactic) medicine, using antidepressants such as amitriptyline, as well as beta-blockers, calcium-channel blockers, or antiseizure medications. Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
362,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",362,"2018-04-19 03:38:44","How to Support a Child with Epilepsy: Information for Parents","How to Support a Child with Epilepsy: Information for Parents Page Content Article BodyMost children with epilepsy live full, active lives that include school, friends, sports, and other activities. How much epilepsy interrupts a child's life depends upon the kind of epilepsy, the success of treatment, and many other factors. Talk to your child's doctor about what activities your child can do and encourage your child to participate.As your child grows, help him become more independent. Driving, college, career, marriage, and raising a family are possible for the vast majority of people with epilepsy.Tips to Encourage & Support a Child with Epilepsy:Learn as much as you can about epilepsy.Discuss epilepsy openly and honestly with your child and help your child talk openly and honestly with others about epilepsy.Avoid saying things that could make your child feel like a problem or burden.Be positive. Praise your child's success.Encourage sports, hobbies, and other interests. Help your child make friends.Work with your child to explain epilepsy to friends, relatives, teachers, and others.Continue family activities and traditions.Make time for yourself without feeling guilty. Respite allows you to take care of yourself so that you are physically and mentally better able to care for your child.Build a support network for you and your child. Resources are available through the Epilepsy Foundation, Parent to Parent-USA,  Parent Training and Information Centers and Family Voices: Family-to-Family Health Information Centers.Establish routines. Routines, schedules, and structure are what keep all busy families going.Have your child take medication at the same time every day.Involve your child in taking charge of her medications. Make sure your child gets enough sleep to lower the risk of seizures.Schedule a regular time for homework.Infants & Toddlers with Epilepsy: Seizures occur most frequently during the first few years of life, during a time when the brain is going through its most dramatic growth and changes. Recognizing and treating seizures as early as possible can help avoid learning and developmental delays. However, diagnosing seizures in infants can be difficult, as they cannot communicate what they are feeling after a seizure or during medical tests. Parents and caregivers observations are especially valuable and necessary for doctor's to effectively treat infants and toddlers with epilepsy.Finding child care for infants & toddlers with epilepsy: One of the biggest challenges parents of infants or toddlers with epilepsy can face is child care. Some child care centers may not admit children with epilepsy. Some refuse to give them emergency anti-seizure medication, even though they may be required to do so by the Americans with Disabilities Act. Your local Epilepsy Foundation can provide information about laws and resources in your area. Click here for more information.School-age Children with Epilepsy:When children are older, having epilepsy can impact many parts of their lives, including how well they do in school, what sports they can play, and how they are treated by friends. The more parents can do to help their child lead an active, normal life, the better.As with all school-age children, it is best to establish routines and set clear rules and limits. Sometimes, parents worry that upsetting a child with epilepsy can lead to a seizure. Usually, if you stay calm and your child is old enough to understand why you are stopping a certain behavior, it should not increase the risk of a seizure. Parents should talk to their child's doctor if they have concerns about the best way to discipline.   ​​​​Special Education Services and Federal Laws​ Chronic Conditions and School Your Right to Special Services Section 504 of the Rehabilitation Act of 1973 Model Section 504 Plan for Students with Epilepsy​Teens with Epilepsy:The preteen and early teen years are difficult for everyone. It is a time of great change, new challenges, and some dangerous temptations. When a child develops epilepsy, the risks, and insecurities that go along with this period are increased. It is important for parents to talk as openly as possible with their child about epilepsy and any other concerns. Dating: This is a normal part of teen life – but it's far from easy. A first date can be nerve-wracking under the best of circumstances, but epilepsy just adds another twist. Teens often worry about is how much and how soon they should tell their date about their epilepsy. They also worry about rejection. Here are some dating tips and ideas to share with your teen. Puberty: Changing bodies affect how children look, feel, and think. Changes in hormones can also affect seizures and medication needs, especially for girls. Sometimes, teens need to change in the amount or type of medication they are taking based on behavioral changes, etc. Social Life: Having friends and fitting in may seem to be all a teen thinks about. Being ""different"" in any way, such as having epilepsy, is not easy. While parents can't make their child popular, they can help their son or daughter understand that having a few good friends is actually more important than having a lot of casual acquaintances. Teens should be encouraged to talk about epilepsy with their friends. Substance Abuse: Alcohol and drugs are dangerous for all children, but even more so for children who are prone to seizures and may be taking medication for epilepsy. Parents should discuss the risks with their child. Then talk some more, and encourage your child's doctor and others your child respects to talk to her, too. Even if it seems like your child is not paying attention, the message may eventually sink in. Discuss not only the risks, but also ways to get out of uncomfortable situations. Responsibility: This is the time when teens are learning to be more independent and that their actions have consequences. If a teen gets epilepsy at this age, it could affect his independence for a while. As a teen begins to spend more time away from home, he will need to start taking on some new responsibilities. Parents should work with your child and doctor to figure out the best way to organize and monitor their condition when they are away from home. When teens learn to drive, parents will need to check their local state driving laws.Transitioning teens with epilepsy to adult health care:Parents and medical professionals should work as a team to prepare children for their move into adulthood and help them learn to manage their health condition. This will include responsibilities such as:Keeping track of medicationsRefilling prescriptionsMaking doctor appointmentsAsking questions of the medical team, etc.For more information and resources on building a care notebook, click here.  Resources for Explaining Epilepsy to Teachers & Friends:Help others in your child's life understand epilepsy. Make sure others know what to do if your child has a seizure. This will help keep your child safe, feel more comfortable, and do better in school. By talking openly and honestly about epilepsy, parents reduce some of the stigma and fear about it. For tools and resources on explaining epilepsy to teachers and friends, visit www.epilepsyclassroom.com. ​Additional Information: Seizures and Epilepsy in Children Epilepsy in Children: Diagnosis & Treatment What is a Child Neurologist? Epilepsy & My Child Toolkit: A Resource for Parents with a Newly Diagnosed Child (National Center for Project Access at the national Epilepsy Foundation) Epilepsy Foundation Last Updated 11/19/2014 Source Developed with funding from the Health Resources and Services Administration, Maternal and Child Health Bureau under grant U23MC08582 for Project Access. (Copyright © 2010 Epilepsy Foundation of America, Inc)"
363,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",363,"2018-04-19 03:38:52","Infantile Spasms: What Parents Need to Know","Infantile Spasms: What Parents Need to Know Page Content​​​Watching your baby's every movement typically brings parents so much joy. But when a baby shows signs and symptoms of a serious neurological condition such as infantile spasms, that joy can quickly turn into concern. Infantile spasms are little seizures with big consequences. Early recognition leads to better outcomes; waiting to seek treatment increases your baby's risk of permanent brain injury. What are Infantile Spasms?Infantile spasms (also known as West syndrome) is a form of epilepsy that occurs in 1 in 2,000 children. It typically begins between 2-12 months of age and peaks between 4-8 months of age.  While these seizures may last only a second or two, they usually occur close together with each spasm occurring every 5-10 seconds in a series. During a spasm, the body stiffens suddenly, the back may arch, and the arms, legs, and head may bend forward. However, infantile spasms can sometimes be hard to notice—perhaps only the eyes roll up or there is a small tummy crunch. They are most common just after a baby wakes up and rarely occur during sleep.  Soon after the spasms begin, parents may notice a number of changes in their baby: Loss of developmental milestones previously learned (e.g., rolling over, sitting, crawling, babbling) Loss of social interactions and smiles Increased fussiness or silenceNote: Talk to your pediatrician if your child is no longer meeting developmental milestones.  Trust your instincts—you know your child best!What Do Infantile Spasms Look Like?  Parents and child care providers and/or anyone wishing to educate a friend or relative about infantile spasms are encouraged to watch this video. We see a baby experiencing a cluster of individual spasms. Each spasm is less than 1 second; she exhibits a look of surprise, a brief stare, and elevation/extension of both arms. In between each spasm, the baby appears to be fine—very typical of infantile spasms. ​Early Diagnosis is Key: It is very important that infantile spasms are diagnosed early. If you suspect your baby may be having infantile spasms, talk to your pediatrician right away. Your child may need to be seen by a pediatric neurologist. If you can, try to video any episodes of your baby having a spasm and show this to your child's doctors. You may be told to take your child to the emergency room so a pediatric neurologist can examine your child. Your child may have to be admitted to the hospital to have a test called video-electroencephalogram (EEG) monitoring. Video-EEG is needed to verify specific brain-wave patterns during the spasms and to document specific patterns in between the spasms. Pediatric neurologists look for a distinct EEG pattern called hypsarrhythmia. The seizures' appearance and EEG are so distinct that the diagnosis of infantile spasms can be made with certainty in most cases. Determining the cause of the spasms may be more difficult.  Causes of Infantile Spasms:There are many causes of infantile spasms; almost any brain abnormality or brain injury can cause them. More than 50 genetic/metabolic diseases are associated with infantile spasms, and many patients have other disorders that cause developmental delays (e.g., cerebral palsy, Down syndrome, tuberous sclerosis, etc.) prior to the onset of the spasms. Determining the cause of infantile spasms is very important, because it affects treatment and prognosis. Treatment Options: The American Academy of Neurology and the Child Neurology Society recommend adrenocorticotropic hormone (ACTH) as the first line of therapy for infantile spasms. This medication is given as a shot. The first doses are given in the hospital so your child can be closely watched for any side effects. Since your child will need to continue to get ACTH shots for about 6 weeks, you will be instructed on how to give your child the injections at home. The goals for this medication are toCompletely stop the infantile spasms.Improve the abnormal EEG.In some cases, pediatric neurologists prescribe the seizure medication Sabril® (vigabatrin). Both drugs work well, but your child's doctor will talk with you about which medicine may be the better choice for your child.What is the Outlook for Children with Infantile Spasms? Even if the infantile spasms stop, many children develop other kinds of epilepsy and have intellectual and/or other developmental disabilities later in life. If the treatment is prompt and successful, the outlook is brighter. Normal development is possible for those who were developing normally before the spasms started. Know the signs to ‘STOP’ Infantile Spasms. Keep this easily remembered acronym in mind: 'STOP’ Infantile Spasms:See the signs: Clusters of sudden, repeated, uncontrolled movements like head bobs or body crunching. Take a video: Record the symptoms and talk to your doctor immediately. Obtain diagnosis: Confirm an irregular brain wave pattern with an EEG test.Prioritize treatment: End spasms to minimize developmental delays Additional Information & Resources: What is a Child Neurologist?Seizures and Epilepsy in ChildrenHow to Support a Child with Epilepsy: Information for ParentsEpilepsy in Children: Diagnosis & TreatmentTalking About Epilepsy with Children, Family & FriendsIs Your Baby's Physical Development on Track? Practice Parameter: Medical Treatment of Infantile Spasms (Report of the American Academy of Neurology and the Child Neurology Society)​Editor's Note: The article is published in recognition of Infantile Spasms Awareness Week (December 1-7) to help parents, as well as physicians and other health care providers, learn more about this disease and its treatments. Check out www.isweek.org for more info and join the conversation on Twitter with #ISAW2017.  Article Body Last Updated 12/1/2017 Source Section on Neurology (Copyright © 2016 American Academy of Pediatrics)"
364,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",364,"2018-04-19 03:38:58",Meningitis,"Meningitis Page Content Article BodyMeningitis is an inflammation of the tissues that cover the brain and spinal cord. The inflammation sometimes affects the brain itself. With early diagnosis and proper treatment, a child with meningitis has a reasonable chance of a good recovery, though some forms of bacterial meningitis develop rapidly and have a high risk of complications.Thanks to vaccines that protect against serious forms of bacterial meningitis, today most cases of meningitis are caused by viruses. The viral form usually is not very serious, except in infants less than three months of age and with certain viruses such as herpes simplex, which typically causes another serious infection. Once meningitis is diagnosed as being caused by a virus, there is no need for antibiotics and recovery should be complete. Bacterial meningitis (several types of bacteria are involved) is a very serious disease. It occurs rarely in developed countries (because of the success of vaccines), but when it does occur, children under the age of two are at greatest risk.The bacteria that cause meningitis often can be found in the mouths and throats of healthy children. But this does not necessarily mean that these children will get the disease. That doesn't happen unless the bacteria get into the bloodstream.We still don't understand exactly why some children get meningitis and others don't, but we do know that certain groups of children are more likely to get the illness. These include the following:Babies, especially those under two months of age (Because their immune systems are not well developed, the bacteria can get into the bloodstream more easily.)Children with recurrent sinus infectionsChildren with recent serious head injuries and skull fracturesChildren who have just had brain surgeryWith prompt diagnosis and treatment, 7 out of 10 children who get bacterial meningitis recover without any complications. However, bear in mind that meningitis is a potentially fatal disease, and in about 2 out of 10 cases, it can lead to serious nervous-system problems, deafness, seizures, paralysis of the arms or legs, or learning difficulties. Because meningitis progresses quickly, it must be detected early and treated aggressively. Notify your pediatrician immediately if your child displays any of the following warning signs:If your child is less than two months old: A fever, decreased appetite, listlessness, or increased crying or irritability warrants a call to your doctor. At this age, the signs of meningitis can be very subtle and difficult to detect. It's better to call early and be wrong than to call too late.If your child is two months to two years old: This is the most common age for meningitis. Look for symptoms such as fever, vomiting, decreased appetite, excessive crankiness, or excessive sleepiness. (His cranky periods might be extreme and his sleepy periods might make it impossible to arouse him.) Seizures along with a fever may be the first signs of meningitis, although most brief, generalized (so-called tonic-clonic) convulsions turn out to be simple febrile seizures, not meningitis. A rash also may be a symptom of this condition.If your child is two to five years old: In addition to the above symptoms, a child of this age with meningitis may complain of a headache, pain in his back, or a stiff neck. He also may object to looking at bright lights.TreatmentIf, after an examination, your pediatrician is concerned that your child may have meningitis, she will conduct a blood test to check for a bacterial infection and also will obtain some spinal fluid by performing a spinal tap, or lumbar puncture (LP). This simple procedure involves inserting a special needle into your child's lower back to draw out spinal fluid. This is usually a safe technique in which fluid is sampled from the bottom of the sac surrounding the spinal cord. Signs of infection in this fluid will confirm that your child has bacterial meningitis. In that case he'll need to be admitted to the hospital for intravenous antibiotics and fluids and for careful observation for complications. During the first days of treatment, your child may not be able to eat or drink, so intravenous fluids will provide the medicine and nutrition he needs. For certain types of meningitis, intravenous antibiotics may be necessary for seven to twenty-one days, depending on the age of the child and the bacteria identified.PreventionSome types of bacterial meningitis can be prevented with vaccines. Ask your pediatrician about the following vaccines.Hib (Haemophilus influenzae type b) VaccineThis vaccine will decrease the chance of children becoming infected with Haemophilus influenzae type b (Hib) bacteria, which was the leading cause of bacterial meningitis among young children before this immunization became available. The vaccine is given by injection to children at two months, four months, and six months, and then again between twelve and fifteen months of age. (Some combined vaccines may allow your doctor to omit the last injection.)Pneumococcal VaccineThis vaccine is effective in preventing many serious infections caused by the pneumococcus bacteria, including meningitis as well as bacteremia (an infection of the bloodstream) and pneumonia. It is recommended starting at two months of age, with additional doses at four, six, and between twelve and fifteen months of age. Some children who have an increased susceptibility to serious infections (these high-risk children include those with abnormally functioning immune systems, sickle cell disease, certain kidney problems, and other chronic conditions) may receive an additional pneumococcal vaccine between ages two and five years.Meningococcal VaccineThere are two kinds of meningococcal vaccines available in the US, but the preferred vaccine for children is called the meningococcal conjugate vaccine (MCV4). Although it can prevent four types of meningococcal disease, it is not routinely recommended for very young children, but rather for young adolescents (eleven to twelve years of age), or teenagers at the time they start high school (or at fifteen years old).Additional Information: Vaccines Your Child Needs Haemophilus Influenzae Type B (Hib) Vaccine: What You Need to KnowPneumococcal Conjugate Vaccine: What You Need to KnowMeningococcal Vaccines: What You Need to KnowMeningococcal Disease: Information for Teens and College Students Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5, 6th Edition (Copyright © 2015 American Academy of Pediatrics)"
365,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",365,"2018-04-19 03:39:02","Migraine Headaches in Children","Migraine Headaches in Children Page Content​​​Your child may have migraines if he or she experiences recurrent headaches with symptom free gaps between them and has some or all of the following symptoms:Throbbing head pain, often on one side of the headNausea or vomitingAbdominal painA visual or sensory sensation, such as blurring or flashes of light or numbness of the hands and feetRelief of headache following sleepA family medical history of migraineIf your child has symptoms suggestive of migraine, your pediatrician will recommend a treatment plan.Migraine Management: Most migraine attacks in children aren't severe and can be managed at home. Talk with your pediatrician about the best methods to avoid triggers and treat migraines. Attacks may be triggered by hormonal changes, certain foods, stress, and other factors. Keeping a headache diary can help a child identify and avoid migraine triggers. A typical headache diary will include notations of the date, time, duration, location, and severity of the headache, as well as environmental factors such as foods eaten before the onset of headache, stressful situations, and other possible triggers. At the first sign of an attack, your child should rest in a quiet, darkened room. Over-the-counter medications such as acetaminophen and ibuprofen are often effective for mild migraine headaches. In many cases children with migraines have fewer, less severe headaches once they've been examined by their pediatrician and reassured that they don't have a serious health problem.Additional Information on HealthyChildren.org: Headaches: When to Call the PediatricianNatural Therapies for Children with Chronic HeadachesFever and Pain Medicine: How Much To Give Your ChildTeens and Headaches Article Body Last Updated 5/17/2016 Source The Big Book of Symptoms: A-Z Guide to Your Child’s Health (Copyright © 2014 American Academy of Pediatrics)"
366,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",366,"2018-04-19 03:39:05","Motion Sickness","Motion Sickness Page Content Article BodyMotion sickness usually starts with a vague feeling of stomach upset. A young child may not be able to describe queasiness, but will demonstrate it by becoming pale and restless, yawning, and crying. Keep an eye out for signs. Click here to listen  Last Updated 11/21/2015 Source A Minute for Kids"
367,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",367,"2018-04-19 03:39:07","Practical Tips for Parents of Children who Take Seizure Medication","Practical Tips for Parents of Children who Take Seizure Medication Page Content​Making sure your child takes medicine exactly as the doctor prescribes is the most important thing you can do to prevent seizures.Important Tips to Remember:              Keep all medications up and away from young children. Some seizure medications are very dangerous if children take an overdose.Create a reminder system for medications. From pill boxes to smartphone reminders, there are many techniques to help you and your child remember to take medication.Do not run out of medications. Request drug refills several days before your child's seizure medications will run out. Depending on the medication, special insurance approval may be needed for a refill to be completed.Discuss with your doctor what to do if your child misses a dose. All epilepsy patients miss medication doses at some point. Depending on the seizure medication, it may be okay to take two doses close together or it may not be.Talk with teachers, school nurses, child care workers, and other caregivers about your child's seizures. Caretakers should know the details of your child's seizures, including what seizures look like, how long seizures typically last, whether or not your child has to be taken to the hospital after a seizure, and any rescue medications needed to make seizures stop. If rescue medications are prescribed, your child's school or child care needs access to these medications. Make sure they are trained to administer the rescue medicine, and have access to your child's seizure action plan.Be honest about how often your child misses taking seizure medicine and how often they have seizures. Your child's doctor cannot make good decisions about how to prescribe seizure medications if they do not have correct information. Be honest with your child's doctor!Allow your older child to transition to being responsible for taking seizure medicine. Some children with epilepsy continue to have seizures into adulthood. Allowing your child to take an active part in treatment, from an early age, helps later as a teenager becomes a young adult. Some ways to start making this transition include having your teen fill pill boxes, set reminder alarms, and make calls to request medication refills.Additional Information from HealthyChildren.org:Seizure Medications for Children & TeensChildren with Epilepsy at School Seizures and Epilepsy in ChildrenEpilepsy in Children: Diagnosis & Treatment Article Body Last Updated 4/27/2016 Source Supported by the Health Resources and Services Administration, Maternal and Child Health Bureau under Cooperative Agreement Number U23MC26252. (Copyright © 2016 American Academy of Pediatrics)"
368,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",368,"2018-04-19 03:39:14","Seizure Medications for Children & Teens","Seizure Medications for Children & Teens Page Content​There are many medicines that treat seizures. But, seizure medications do not cure seizures, they control seizures. Some medications only work to control for specific types of seizures. Other medications work to control a wide variety of seizure types. Choosing the Right Medication Choosing the right medication depends on a number of factors including:Type of seizure a child hasAge of the childOther medical problems the child hasOther medicines the child takesSide effects of the medicineSeizure Medication SafetyIt is important to understand how to properly take a seizure medicine. Some medications are given once a day while others are given twice or three times a day. Rarely, seizure medications may be given up to four times per day. Knowing both the brand name and generic name, the dose, and when to take the medication is very important. Additionally, being familiar with possible side effects of the medication and any necessary blood tests while on the medication is helpful.Only a few of the widely used medications used to treat seizures are approved by the FDA for use in children. Your doctor can tell you the details of your child's specific medication including the indications for use and its safety profile. Types of Seizure MedicationThere are many different types of seizures and some medications work better for certain seizures types. Some common seizure types include focal, generalized tonic-clonic, and absence. There is also a growing number of newer medications that can be used to treat specific types of seizures.Tonic-clonic seizuresCommon medications used for generalized tonic-clonic seizures include:ClobazamLamotrigineLevetiracetamRufinamideTopiramateValproateZonisamideNote: Many of these medications are also used to treat focal seizures. Focal seizuresCommon medications used for focal seizures include:CarbamazepineOxcarbazepineLacosamideAbsence seizuresThe most classic medication used for absence seizures is ethosuximide, but valproate is also commonly prescribed. Side Effects from Seizure MedicationsAll medications, even over-the-counter medicines, have the risk of side effects. Therefore, all seizures medications have some risk of side effects. Most children have few or no problems with side effects from seizure medications. Side effects vary by medication but may include:Feeling sleepyRashMood changesIrritabilityStomach problemsSome less common side effects are hard to see and may affect the liver, kidneys, or blood cells. To monitor for these side effects, blood work may be done. Some side effects occur more often at higher doses and may be avoided if a lower dose of the medication can be used. When a child shows signs of a potential side effect from a seizure medication, it is important to consider other possible causes of that side effect. For example, a rash may be due to a viral illness or an exposure and may not be due to a seizure medication. However, because rare cases of serious rashes from seizure medications can occur, it is important to watch carefully and notify your child's primary care doctor and epilepsy doctor in the event of a rash.Bone health Some seizure medication affects how children build strong bones. This problem is especially important for children who need to take certain seizure medications for many years. If your child needs seizure medicines for more than a year or two, ask your doctor if they need to be monitored for bone health. Interactions with birth control Teen and young adult epilepsy patients should be aware that some seizure medications can interact with certain forms of birth control. This can result in abnormally high or low levels of the seizure medication or ineffectiveness of the birth control medication. This can lead to poor seizure control and/or an unintended pregnancy. Seizure medications during pregnancy Women who are taking certain seizure medications when they become pregnant have an increased risk of having a baby with birth defects. Some medicines are safer than others during pregnancy. Pregnancy also changes the way a woman's body metabolizes seizure medicine, so doctors monitor pregnant patients very carefully. It is important to discuss seizure medication choices with your doctor prior to becoming pregnant, if possible.Long-term Seizure Medication  Parents often worry about giving a child medication every day to prevent seizures. It is important to know that seizure medications are usually very successful in preventing seizures and with proper monitoring they are quite safe. A child who has uncontrolled seizures is at risk of a variety of dangers including injury from falls, accidents, drowning, or even death. See Seizure Safety: Tips for Parents. Rescue Medications If your child has epilepsy, you should also talk with your doctor about rescue medications. Rescue medications are used when a child has a very long seizure (usually 5 minutes or longer) or has a cluster of multiple seizures in one day. There are a variety of options for rescue medications. These include medications that are given as a dissolving tablet, a rectal gel, or a nasal spray. Some commonly prescribed rescue medicines are diazepam, clonazepam, and midazolam.Additional Information from HealthyChildren.org:Practical Tips for Parents of Children who Take Seizure MedicineChildren with Epilepsy at School Seizures and Epilepsy in ChildrenEpilepsy in Children: Diagnosis & Treatment​ Article Body Last Updated 4/27/2016 Source Supported by the Health Resources and Services Administration, Maternal and Child Health Bureau under Cooperative Agreement Number U23MC26252. (Copyright © 2016 American Academy of Pediatrics)"
369,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",369,"2018-04-19 03:39:19","Seizure Safety: Tips for Parents","Seizure Safety: Tips for Parents Page Content Article Body​Parents play a key role in making sure their child with epilepsy is safe, while still allowing him or her to participate in many of the typical activities of childhood. Guidelines for Keeping Your Child Safe at Home & in the CommunityThere are a few basic things you can do to make sure you child is safe in a variety of situations.Teach family members and friends proper seizure first aid.Inform family and friends when to call for help (i.e., when your child's seizure should be considered an emergency).Have your child wear medical alert bracelet or necklace that says he or she has epilepsy.Ensure that your child takes his or her medicine on time, every day. This is very important to reduce chance of seizures.Make sure your child gets enough sleep. Not getting enough can lead to more seizures.Consider a helmet for your child, if he or she has seizures that cause frequent falls.A Seizure Action Plan can be a useful tool to share with family and friends. It will help them all know what to do if your child has a seizure.Simple Steps to ""Safety Proof"" Your HomeThere are many simple things you can do to make your home safer for your child. Place padding on sharp corners, like those on tables and counters.Avoid glass tables.Have your child sleep on a low-lying bed.Use non-slip carpet.Avoid throw rugs.If your child wanders during a seizure, try the following: Shut and lock doors that lead outside. Consider putting alarms on doors to alert you if a door has been opened.If your older child is ever at home alone, be sure a neighbor or friend has a house key to check on your child.Put a locking ""safety gate"" at the top of stairs.Heat Sources & Fires Can Be Dangerous If your child has uncontrolled seizures, you need be extra careful when around all heat sources. Heat safety tips for your kitchen:Have your child use a microwave for cooking – this is safest.If your child needs to use a stovetop, make sure he or she uses the back burner. Electric burners are safer than flames.Consider serving hot things right off the stove onto plates.Make sure cups of hot liquid, like hot chocolate, have lids to avoid burns from spills.Heat safety tips for around the house:Be aware that hairdryers, curling and clothing irons, and open flames (fireplaces, campfires, candles) can be safety hazards and need extra caution.Hot water can cause burns, so set the maximum hot water temperature in your house to 110 degrees Fahrenheit or less.Consider placing guards on open fireplaces, wood stoves, and radiators.Do not allow anyone to smoke in your home.Do not allow your child to use or play with matches. High Places Need Extra Precaution If your child is still having seizures, he or she needs to be very careful around heights. Put carpeting on staircases and at the bottom of stairs to reduce injuries from falls and slipping.Avoid unprotected heights, like ladders. If your child wants to go up high, at home, school or for recreation, make sure he or she is wearing a safety harness and helmet.Use Power Tools & Outdoor Equipment with Care There are simple things you can do to make sure you child is safe when using any tools or electric equipment. Make sure all equipment for cutting, chopping, and drilling has safety guards.Make sure electric or gas powered equipment (lawn mowers, etc.) have an automatic shut-off switch – this means that it stops when you stop holding it.When using any tools, make sure your child wears protective eyewear, gloves and appropriate footwear.Water can be Dangerous – Both Inside and Outside Your HomeWhen your child is around water, whether it is in the bathroom or the local pool, extra safety precautions need to be in place. Children with seizures should never bathe and swim without close supervision. Have your child take a shower rather than a bath. If you child does take a bath, keep the water level low. Ideally stay with your child while he or she is taking a bath. Ask for the bathroom door to remain unlocked.Use safety glass, plastic, or a shower curtain for a shower door. Use safety glass in mirrors, as well.Have your child wear a life jacket when swimming in a large body of water to ensure that he or she always stays above the water's surface. Make sure your child is never left unsupervised while in a pool, hot tub, inflatable pool, wading pool, etc.Encourage Children to Participate in Sports - Safely! Playing sports can promote physical health, build community and enhance self-esteem. Children with well-controlled seizures can enjoy nearly all sports, from baseball to basketball to soccer.Contact sports can even be OK for some children with seizures, since there is no evidence they induce seizures.Swimming and water sports, harnessed rock climbing, horseback riding, and gymnastics can also be safe with for children with well-controlled seizures, as long as there is appropriate supervision. Free climbing, skydiving, hang-gliding, and scuba diving are not safe.Tips for Bicycle & Driving Safety Bicycle safety begins at a young age. Safety rules also apply to roller blades, inline skates, scooters (anything with wheels). Helmets are essential to protect a child from scalp and brain injuries, as well as facial bruising if a seizure were to occur. Driving is not permitted when seizures are not controlled. State laws differ as to when an individual with epilepsy can drive. Know your state's laws about driving with epilepsy.For additional questions or concerns, contact your child's pediatrician. Additional Information from HealthyChildren.org: Seizures and Epilepsy in Children Epilepsy in Children: Diagnosis & Treatment Children with Epilepsy at School How to Support a Child with Epilepsy: Information for Parents What is a Child Neurologist? When Your Child Needs Emergency Medical Services   Last Updated 11/10/2015 Source Developed with funding from the Health Resources and Services Administration, Maternal and Child Health Bureau under Cooperative Agreement Number U23MC08582 for Project Access and Cooperative Agreement Number U23MC26252."
370,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",370,"2018-04-19 03:39:22","Seizures and Epilepsy in Children","Seizures and Epilepsy in Children Page ContentWhat is a Seizure? Seizures are sudden events that cause temporary changes in physical movement, sensation, behavior or consciousness. They are caused by abnormal electrical and chemical changes in the brain.There are many different types of seizures. Some last for only a few seconds, while others may last a few minutes. The specific type of seizure a person has depends on where in the brain the seizure starts, how the seizure spreads  and how much (and what part) of the brain is involved. Seizures might include:Loss of consciousnessConvulsions (whole body shaking)ConfusionBrief periods of staringA sudden feeling of fear or panicUncontrolled shaking of an arm or legFlexing, stiffening, jerking, or twitching of the upper bodyNodding of the headWhat is Epilepsy?The term epilepsy is used to describe seizures that occur repeatedly over time without an acute illness (like fever) or an acute brain injury. Sometimes, the cause of the recurring seizures is known (symptomatic epilepsy), and sometimes it is not (idiopathic epilepsy). A doctor would likely diagnose a child with epilepsy if the following were true:The child has had one or more unprovoked seizures.The doctor thinks the child is likely to have a seizure againThe child's seizures are not directly caused by another medical condition, like diabetes, a severe infection or an acute brain injury.​1 in 26  The video above is part of the 1 in 26 epilepsy education program for middle school students that was developed by the Epilepsy Foundation Western/Central Pennsylvania (EFWCP). Featuring children living with epilepsy and their families, this video introduces the statistic that 1 in 26 Americans can expect to develop epilepsy in their lifetime (Institute of Medicine, 2012).​ Common Seizure Types:Doctor's divide seizures into two basic categories based on how much of the brain is involved. These include: Generalized seizures that involve the whole brain.  Focal seizures that start in one specific part of the brain.For more detailed information on specific seizures types​.​Common Generalized Seizures: Convulsive seizures (also called generalized tonic-clonic seizures) involve the whole body. These seizures used to be called ""grand mal"" seizures. They are the most dramatic type of seizure, causing rapid, rhythmic and sometimes violent shaking movements, often with loss of consciousness. These can sometimes start in one part of the brain, causing one part of the body to move, and then progress to the entire brain and movements on both sides of the body. These seizures usually last for 2 or 3 minutes and will almost always end on their own.Convulsive seizures occur in about 5 out of every 100 people at some time during childhood. It is important to note that not everyone who has a single convulsive seizure will go on to develop epilepsy. Absence seizures (previously called ""petit mal"" seizures) are very short episodes with a vacant stare or a brief (few seconds) lapse of attention. They may be accompanied by other subtle symptoms like eyelid fluttering, rapid eye blinking, lip smacking. These occur mainly in young children and may be so subtle that they aren't noticed until they begin affecting schoolwork.Common Focal Seizures: Focal seizures (previously called complex partial seizures) involve abnormal electrical activity in one part of the brain. During these seizures a person can be confused and consciousness is impaired. They often engage in random, repetitive and purposeless activities like wringing the hands or walking slowly in circles. The person is unaware of what is going on around them and may be unable to talk normally. This type of seizure typically lasts 1 to 2 minutes. Focal seizures can involve jerking of one or more parts of the body, or sensory changes like smells or tingling feelings that may not be obvious to onlookers. During the seizure the person is fully aware of what is going on. These seizures where consciousness is not impaired have been called Simple Partial Seizures.Focal seizures can start in one area of the brain, and spread to involve both sides of the brain. In some instances a focal seizure can progress to a convulsive seizure.Other Disorders That Can Look Like Seizures:Some children experience sudden episodes that might masquerade or imitate seizures, but are really not. Examples include:Breath holding Fainting(syncope)Facial or body twitching (myoclonus)Sleep disorders (night terrors, sleepwalking, and cataplexy)They may occur just once or may recur over a limited time period. Again, although these episodes may resemble epilepsy, they are not, and they require quite different diagnostic tests and treatment.If Your Child is Having a Convulsion:Most seizures will stop on their own and do not require immediate medical treatment. If your child is having a convulsion, protect her from injuring herself by laying her on her side with her hips higher than her head, so she will not choke if she vomits. Do not put anything in the mouth.  If the convulsion does not stop within five minutes or is unusually severe (difficulty breathing, choking, blueness of the skin, having several in a row), call 911 for emergency medical help. Do not leave your child unattended, however. After the seizure stops, call the pediatrician immediately and arrange to meet in the doctor's office or the nearest emergency department. Also call your doctor if your child is on an anticonvulsant medication, since this may mean that the dosage must be adjusted. If your child has diabetes, is injured or has a seizure in the water, this is always an emergency and 911 should be called immediately. If your child has a fever, the pediatrician will check to see if there is an infection. If there is no fever and this was your child's first convulsion, the doctor will try to determine other possible causes by asking if there is a family history of seizures or if your child has had any recent head injury. He will examine your child and also may order blood tests, pictures of the brain using computed tomography (CAT scan) or magnetic resonance imaging (MRI), or testing with an electroencephalogram (EEG), which measures the electrical activity of the brain. Sometimes a spinal tap will be performed to obtain a specimen of spinal fluid that can be examined for some causes of convulsions such as meningitis, an infection of the lining of the brain. If no explanation or cause can be found for the seizures, the doctor may consult a pediatric neurologist, a pediatrician who specializes in disorders of the nervous system. If your child has had a febrile convulsion, some parents may try controlling the fever using acetaminophen and sponging. However, these approaches do not prevent future febrile seizures, but only make the child more comfortable. If a bacterial infection is present, your doctor will probably prescribe an antibiotic. If a serious infection such as meningitis is responsible for the seizure, your child will have to be hospitalized for further treatment. Also, when seizures are caused by abnormal amounts of sugar, sodium, or calcium in the blood, hospitalization may be required so that the cause can be found and the imbalances corrected. If epilepsy is diagnosed, your child usually will be placed on an anticonvulsant medication. When the proper dosage is maintained, the seizures can almost always be completely controlled. Your child may need to have her blood checked periodically after starting some medications to make certain there is an adequate amount present. She also may need periodic EEGs. Medication usually is continued until there have been no seizures for a year or two.Remember...As frightening as seizures can be, it's encouraging to know that the likelihood that your child will have another one drops greatly as she gets older. (About 1 in 100 adults 18 and older have active epilepsy). Unfortunately, a great deal of misunderstanding and confusion about seizures still exists, so it is important that your child's friends and teachers become educated about her condition.If you need additional support or information, consult with your pediatrician or contact your local or state branch of the Epilepsy Foundation of America.Additional Information: Epilepsy in Children: Diagnosis & Treatment How to Support a Child with Epilepsy: Information for Parents What is a Child Neurologist? Febrile Seizures Treatment of the Child with a First Unprovoked Seizure (AAP Practice Guideline Endorsement) Febrile Seizures: Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure (AAP Clinical Practice Guideline)​ Article Body Last Updated 2/4/2016 Source Developed with funding from the Health Resources and Services Administration, Maternal and Child Health Bureau under grant U23MC08582 for Project Access. (Copyright © 2010 Epilepsy Foundation of America, Inc)"
371,17,"2018-04-19 02:48:19","Head, Neck & Nervous System",371,"2018-04-19 03:39:26","Talking About Epilepsy with Children, Family & Friends","Talking About Epilepsy with Children, Family & Friends Page ContentParents of children with epilepsy will most likely need to explain many times and over many years what the condition is to not only your child, but to other children and family and friends of all different ages. Sometimes, it can be hard to talk about epilepsy. There is fear and misunderstanding about epilepsy and seizures, but epilepsy is a common neurological condition—an estimated 0.6% of children have active epilepsy. Talking about epilepsy can help people realize that children with the condition are just like other children and can lead full, active lives. Talking honestly and openly about epilepsy will also help teachers, coaches, babysitters, family, friends, and other people who are with you children understand what epilepsy is (and what is not). You will also be able to tell them what to do in case of a seizure. See Seizure Safety: Tips for Parents. General Tips on Talking about Epilepsy:Try to stay matter-of-fact and positive.Encourage questions.Have resources ready to share.Practice some conversation starters.The key message is that people with epilepsy deserve respect and understanding and can lead full, happy lives like everyone else.Talking to Your Child or Other Children about Epilepsy:Be positive and use easy to understand language, not complex terms.Encourage them to ask questions and be honest about their fears.If you don't know the answer to a question, tell them you will find out and then follow through.Share stories with pictures. You may want to share them with your child's teacher, too.If your child has epilepsy, help them understand their seizures, medications, or treatments. Remember to continue these conversations as your child grows and is prepared to understand more details about his or her seizures and treatments.Helping Your Child with Epilepsy Talk about It:  Your child may be nervous to talk about having seizures and epilepsy. They may not want to talk about it right after diagnosis and that's ok. They don't have to tell everyone; they may want to wait until they have had some time to think about it. When are they ready to talk, here are some things parents can do to help: Explain why it's important to talk about epilepsy and why educating others will help reduce fear and misunderstanding. Let them know how important it is for others to know what to do if they have a seizure.Give them tips on conversation starters.Help them understand what kind of questions they may be asked and how they could answer them. Encourage them to keep talking with you about how they feel. Let them know you want to hear their concerns and questions.Additional Information from HealthyChildren.org:Children with Epilepsy at School Seizures and Epilepsy in ChildrenEpilepsy in Children: Diagnosis & TreatmentHow to Support a Child with Epilepsy: Information for ParentsAdditional Information from the Epilepsy Foundation:Start a Conversation About Epilepsy and SeizuresExplaining Epilepsy to Children and FamilyTalking with Friends and FamilyTalking with School and Medical Staff Article Body Last Updated 4/27/2016 Source Supported by the Health Resources and Services Administration, Maternal and Child Health Bureau under Cooperative Agreement Number U23MC26252. (Copyright © 2016 American Academy of Pediatrics)"
372,18,"2018-04-19 02:48:19",Heart,372,"2018-04-19 03:39:31","Birth Control for Young Women with a Congenital Heart Defect","Birth Control for Young Women with a Congenital Heart Defect Page Content​Understanding the risks and benefits of different birth control methods is important for all women. For women with a congenital heart defect (CHD), choosing the right birth control is critical to maintaining a healthy heart.  Questions to Ask Yourself:Selecting birth control when you have a CHD requires you to think about all aspects of your life.  Some typical questions might be:Do I ever want to become pregnant? If so, when might that be? Will pregnancy be too risky with my heart condition?  Some women with a CHD have a very high risk for medical complications if they become pregnant. If this is you, it is important to use a very effective form of birth control or to consider permanent sterilization.If pregnancy could be dangerous to your health but you would like to have a family, talk to your doctor about other options, such as adoption or surrogacy. Deciding not to have children is a perfectly acceptable option, too, if that is what you choose.Types of Birth Control:Women with a CHD who are able to have a safe or low risk pregnancy but are not ready to become pregnant yet have many options for birth control. Some methods are more effective than others and some also last longer than others. Some methods contain the hormones estrogen and/or progesterone (e.g. oral medications, skin patches, vaginal rings, implants).Some forms of birth control use a ""barrier"" method to block sperm from entering the uterus (e.g. condoms, copper intrauterine devices or IUDs, diaphragms).Benefits & Risks of Birth Control Methods:There are different risks and success rates for the various forms of birth control.Condoms ​have little physical risk to women. They are also highly effective at protecting against sexually transmitted diseases. However, they do not always work well at preventing pregnancy. In fact, they have a failure rate as high as 30%.Birth control pills are usually reliable at preventing pregnancy. However, some forms bith control pills contain estrogen which can increase the risk of stroke and other medical complications related to the increased risk of blood clots. Estrogen is not recommended if you have a CHD and are at increased risk of forming blood clots, especially if you have an artificial heart valve or have had a Fontan operation.Progesterone-only birth control methods have a lower risk of blood clots. Progesterone can be taken as a pill, placed as an implant under the skin, given as monthly injections or used in an IUD. A progesterone pill must be taken at the same time every day. Progesterone forms of birth control are often good choices if you have a CHD. They can be highly effective when they are used the right way. Progesterone IUD is a very effective method if you do not want to become pregnant for at least a few years.   Two forms of birth control are recommended if you are sure you never want to become pregnant or are at very high risk for a dangerous pregnancy. You may consider a tubal ligation or other permanent form of birth control, as well. If you have a long-term male partner, you may consider asking him to have a vasectomy.   Talk to your gynecologist about which form of birth control is best for you based on the recommendations of your congenital cardiologist.  ​​Additional Information & Resources: Sexually Transmitted Infections PreventionSexuality Education for Children and Adolescents (AAP Clinical Report)Birth Control Methods Fact Sheet (WomensHealth.gov)​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​ Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
373,18,"2018-04-19 02:48:19",Heart,373,"2018-04-19 03:39:35","Cardiac Conditions in Teens","Cardiac Conditions in Teens Page Content Article BodyTeenagers frequently experience chest pain. Rarely, though, is the symptom related to the heart. Nevertheless, such complaints should be brought to the attention of your pediatrician, who will diagnose the problem through process of elimination. “Usually, just asking the patient questions points us to the source of the pain,” says Dr. Reginald L. Washington, a pediatric cardiologist from Denver. Among the red flags he looks for are chest pain upon physical exertion and chest pain accompanied by dizziness. “Those situations would warrant further evaluation,” he says, “but most of the time the cause turns out to be anxiety, too much caffeine, asthma, muscle strain or costochondritis.” The latter condition, an inflammation of the chest wall, is treated with rest, over-the counter anti-inflammatory medications and heat. High Blood Pressure (Hypertension) and High Blood Cholesterol (Hypercholesteremia) Doctors once believed that virtually all high blood pressure in youngsters was a complication of another medical condition, such as kidney disease. We now know that even infants can develop primary hypertension, also referred to as essential hypertension. Abnormally elevated levels of the fatlike substance cholesterol in the circulation are also sometimes seen in teenagers. Either problem can pave the way for a future heart attack, cerebral stroke, renal failure, or blindness, among other conditions. Symptoms that Suggest Primary Hypertension or Hypercholesteremia Include: Dizziness and/or headache from high blood pressure High cholesterol does not cause symptoms in teenagers How Hypertension and Hypercholesteremia are Diagnosed Diagnostic measures include physical examination and thorough medical history, plus one or more of the following procedures: (1) multiple blood pressure readings (2) cholesterol blood test. In teenagers, an abnormally high blood-pressure measurement calls for a second reading, then several additional readings over the course of other office visits before a definitive diagnosis is made. The first number represents the systolic pressure: the peak pressure within the blood vessels when the heart contracts. The second number expresses the diastolic blood pressure reached when the heart relaxes between beats. If the blood pressure remains elevated, more extensive laboratory tests would be  ordered, along with an electrocardiogram (EKG). Memo to Mom and Dad: Stress can contribute to hypertension. As parents of a teenager, have you had your blood pressure taken lately? How Hypertension and Hypercholesteremia are Treated Improved diet and exercise: Both hypertension and hypercholesteremia are uncommon among teenagers. Often, studying the family tree reveals a genetic thread entwined throughout its branches. About half of all youngsters diagnosed with hypertension and two-thirds of those with high cholesterol have a hereditary predisposition to the disorder. “The rest of the cases are due to poor dietary practices and a lack of physical activity,” says Dr. Washington. “In general, those are the easiest to treat. If they learn to eat healthily and engage in aerobic exercise, almost all of them can get their blood pressure and cholesterol down into a normal range.” Even if your youngster’s blood pressure and cholesterol level are normal, we advise following the sensible eating plan. Getting into the habit of choosing foods that are low in saturated fat, cholesterol and salt may help prevent cardiovascular disease later in life. Drug therapy: Adolescents who fall into the high-risk categories for hypertension or hypercholesteremia may require medication in addition to modifying their diet and lifestyle. Agents typically used to bring down the concentration of cholesterol in the blood include cholestyramine, clofibrate and statins. To lower blood pressure, a pediatrician might prescribe a diuretic in combination with an agent from one of four families: beta-blockers, angiotensinconverting-enzyme inhibitors or ACE inhibitors; calcium-channel blockers; and alpha-beta blockers. Diuretics, also known as “water pills,” act on the kidneys to flush excess water and sodium (salt) from the body. The other medications reduce blood pressure through various mechanisms. Helping Teenagers to Help Themselves Youngsters with or without hypertension or hypercholesteremia should be encouraged to: Maintain a healthy weight. Engage in aerobic exercise for at least thirty minutes per day. Abstain from using tobacco or alcohol. Learn techniques for relieving stress, be it exercise, deep breathing or meditation. Consult the pediatrician if considering taking birth-control pills. Although neither condition is common in healthy teens, oral contraceptives can worsen both high blood pressure and high blood cholesterol.   Mitral Valve Prolapse (MVP) Four flap like valves regulate the flow of blood through the heart’s four chambers. The mitral valve is situated in the left side of the heart, the side that receives freshly oxygenated blood from the lung, then pumps it out to the circulation. Under normal circumstances, the valve opens to let blood pass from the upper left chamber (the left atrium) into the lower left chamber (the left ventricle). Approximately one in eight otherwise healthy adolescents and young adults are found to have mitral valve prolapse. For reasons that remain unclear, one or both flippers billows out (prolapses) into the upper chamber instead of snapping shut. This can produce a clicking sound, audible through the pediatrician's stethoscope. Occasionally, blood may leak backward into the atrium, causing a murmur.  “The sounds usually come and go,” says Dr. Washington. Some youngsters with mitral valve prolapse have both a click and a murmur, while others have no abnormal heart noises at all. Symptoms that Suggest Mitral Valve Prolapse May Include: Abnormal heart murmur Fluttering sensation in the chest, as if the heart were racing or skipping a beat Shortness of breath Headache Sharp, fleeting chest pain Nineteen out of twenty people with mitral valve prolapse do not exhibit any symptoms; the condition is discovered during a routine physical. How Mitral Valve Prolapse is Diagnosed Physical examination and thorough medical history, plus one or more of the following procedures: Stethoscopic exam echocardiogram chest X ray How Mitral Valve Prolapse is Treated “The vast majority of people with mitral valve prolapse can go about their lives without having to worry about the condition or restrict athletic activities,” explains Dr. Washington. Under certain circumstances, however, a leaky mitral valve can become infected. To reduce the risk of endocarditis, rare though it may be, the current recommendation is for antibiotics to be taken just prior to dental appointments and surgical procedures. Helping Teenagers to Help Themselves Reducing caffeine consumption can help alleviate heart palpitations. Remember that caffeine is present not only in coffee but in soda, chocolate and tea. Heart Murmur: Language of the Heart “A heart murmur,” explains Dr. Washington, “is merely the sound of the heart vibrating slightly or valves opening and closing as blood flows through it. There are probably fifty different types, each with its own distinctive sound. Most of them,” he emphasizes, “are perfectly normal.” As many as four in five young people have these “innocent” murmurs now and then. Unless the murmur occurs during a doctor’s visit, it generally goes undetected. An abnormal murmur, which a pediatrician can identify with a stethoscope, indicates a heart condition that may require further diagnostic testing, possibly by a pediatric cardiologist. Possible causes include infections of the heart (endocarditis, myocarditis), faulty valves and cardiac defects that had been present since birth. Normal heart murmurs don’t call for limits on activities. With abnormal murmurs, says Dr. Washington, “the underlying cause will determine whether restrictions are necessary.” Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
374,18,"2018-04-19 02:48:19",Heart,374,"2018-04-19 03:40:04","Challenges Faced by Parents of Children with Congenital Heart Disease","Challenges Faced by Parents of Children with Congenital Heart Disease Page Content​​​The first thing most parents want to know about their unborn baby is whether the baby is healthy. From the moment parents hear the words, ""Your child has a heart defect,"" they are thrust into a world they were not expecting. Even before the child is born, the joy of giving birth is often coupled with so many unique and complicated feelings—ranging from fear, guilt, sadness, shame, and confusion. Many feel ashamed of these feelings and try to suppress them, but it is important to remember these feelings are common and expected.About Congenital Heart DefectsCongenital Heart Disease (CHD) is the most common type of birth defect affecting 8 out of every 1,000 newborns.  Each year, about 35,000 babies in the Unites States are diagnosed with CHD. Nearly 25% of those are critical congenital heart defects—ones that require surgery or other interventions within the first year of life to survive. Parents of these children often sit by their child's side in the hospital hoping and praying their child survives. As a result of dramatic advances in the medical and surgical management of CHD, 85% of infants with CHD are now expected to survive to adulthood, and CHD is regarded as a chronic disease rather than a terminal one. However, survival rates for children with critical congenital heart defects is lower; they often need specialized medical care throughout their lifetime.  Understanding Unique Parenting ChallengesAll parents are caregivers, but parents of children with CHD have extra challenges. Learning ""normal"" and more specialized parenting skills:Aside from the typical stresses and adjustments new parents face, in most cases, parents who have a baby with CHD are also struggling to care for a baby who may have spent months in the Neonatal Intensive Care Unit (NICU) and may have tubes or attachments to his or her tiny body. When babies have open-heart surgeries, their ability to learn to eat can be compromised. Some babies have to be fed through a feeding tube. In addition to feeding issues, many children with CHD have trouble gaining weight and must go on special high-calorie diets. Becoming an expert and advocate. Knowledge is power. Parents often immerse themselves into learning as much as they possibly can about their child's diagnosis, medication, and treatment plan. It is important to avoid ""internet overload"" by sticking to reputable websites. See the additional resources at the end of this article.  Making changes to safeguard their child's health:Infants and children with CHD have weaker immune systems than the average child. They can end up in the hospital for illnesses that others recover from on their own. Thus, many parents take extra precautions to try to keep their child healthy. This may mean having serious talks with friends and family about getting their annual flu shot and a Tdap shot to prevent whooping cough. See How to Cocoon a Newborn: Only an E-Mail Away! for more information and tips. As their child grows, parents must strike a balance between letting their child live ""normally"" and protecting them. Walking the line between healthy limits and over-protectiveness is an ongoing concern. Struggling with the financial component of care: For a child with CHD, surgical costs can be astronomical, even with health insurance. The costs of medicines and doctor appointments add up quickly, too. Many children with CHD are on multiple medications, some taken several times a day. It's not unusual for children who've had open-heart surgery to come home on six or more different medications. Caring for their other children:If there are siblings in the family, parents must also take their needs into consideration. Young children, especially, may have fears and anxieties about their brother or sister's condition that they aren't voicing. It is important to spend one-on-one time with each child and time together as a family that isn't focused on the CHD.Educating the school and others: Often, sending a child with CHD to preschool or school, or even having siblings in school, can pose challenges for parents. Again, avoiding major illnesses is a concern. Educating school staff about CHD and their child's limitations can also be difficult. Sometimes, parents get everyone together who will be working with their child, so that they all understand the condition or defect. Living with persistent uncertainty:Even if their child doesn't need any more procedures, there will always be doctor appointments that will inevitably dredge up some old memories and new fears. As children grow, it is also natural for parents to feel fear about the inherent risks of CHD and the knowns and unknowns about their child's lifelong care. The journey is never over, so support plays a big role in these parents' lives. Why Support is So ImportantParents need for all kinds of support – informational, emotional, and instrumental – to be able to face the stress of caring for a child with CHD.  Connecting with other parents of children with a CHD:Parents and other family members are encouraged to connect with others who also have a child in their family with a heart defect. Other parents, for example, can provide a credible model of how to cope in a positive way with exceptional life circumstances. Talking to a trained mental health professional: Parents who seek the assistance of mental health professionals typically experience reductions in stress, depression and anxiety, as well as improved sleep and life satisfaction. The Silver Lining Life with a child diagnosed with CHD can be overwhelming, stressful, and in some cases tragic. However, some families have recognized a silver lining in having a family member with a complex medical condition like CHD. For example, siblings can be more resilient—demonstrating increased compassion, a greater sense of wonder and joy, and a greater appreciation for life. Many parents' outlook on life and priorities can change, as well, to appreciate the ""little things in life"" a lot more. Additional Resources: Little Heart Guide: A Parent and Caregiver's Guide (Mended Little Hearts) – Guide for families affected by a CHD from diagnosis throughout the lifespan. Caregiving for Children with a CHD: Three Parents' Perspectives (Mended Little Hearts) - Parents of ""heart children"" to share their experiences. It's My Heart (Children's Heart Foundation) – Provides descriptions of the types of CHDs as well as explanations of the various tests, procedures and treatments.When Your Child has a Heart Defect: Planning Ahead for Lifelong Heart Health (Adult Congenital Heart Association) - Designed to help parents of children born with CHD plan ahead for lifelong heart health. Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​ Article Body Last Updated 5/19/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
375,18,"2018-04-19 02:48:19",Heart,375,"2018-04-19 03:40:09","Common Heart Defects","Common Heart Defects Page Content Article Body​Congenital heart defects are structural problems arising from abnormal formation of the heart or major blood vessels. At least 1% of all live-born infants have a heart defect. The cause of a heart defect is most often unknown. Some defects may be small and may cause your child few problems; others are life-threatening.Types of Congenital Heart DefectsThere are 18 types of congenital heart defects recognized and ​many additional anatomic variations. The more common heart defects are listed below:​ Atrial Septal Defect (ASD)Atrioventricular Canal DefectCoarctation of the Aorta (CoA)Hypoplastic Left Heart Syndrome (HLHS)Pulmonary AtresiaPulmonary Stenosis (PS)Tetralogy of FallotTotal Anomalous Pulmonary Venous Connection (TAPVC)Transposition of the Great ArteriesTricuspid AtresiaTruncus ArteriosusVentricular Septal DefectOutlook for Children Born with a Heart DefectEven if your baby is born with a heart defect, it is very likely nowadays that he or she can live a normal adult life and overcome the problem. The many advances in the diagnosis and treatment have made it possible to correct defects via surgery and heart catheterization. Even the most difficult cases have hope now.The ​​diagnosis and treatment for other heart defects will continue to improve ​with new advancements and ​research. ​Talk with your child's pediatric heart surgeon if you have specific questions about your child's condition, treatment options, and expected outcomes. Additional Information What is a Pediatric Heart Surgeon?Cardiac Conditions in TeensYour Family Health History & Genetics​ Last Updated 11/21/2015 Source Newborn Intensive Care: What Every Parent Needs to Know, 3rd Edition (Copyright © 2010 American Academy of Pediatrics)"
376,18,"2018-04-19 02:48:19",Heart,376,"2018-04-19 03:40:16","Genetics and Congenital Heart Defects","Genetics and Congenital Heart Defects Page Content​​​​A congenital heart defect (CHD) is the most common type of birth defect. It is estimated that 2 to 3 million people in the United States have a CHD.Over the last few decades, treatments for CHDs have improved—meaning more children born with a CHD are growing up to have children of their own. If you have a CHD, you might wonder what the risk is for your child to also have a CHD. You might also wonder whether pregnancy will affect your health. These are very important questions to discuss with your congenital cardiologist and perhaps other specialists, such as a maternal-fetal-medicine specialist and a geneticist or genetic counselor. What causes a congenital heart defect?CHDs are caused by genetics, the environment, or a combination of both. Some known genetic causes include:Chromosome abnormalities: Extra or missing chromosomes.Gene mutation: A change to the DNA sequence or order that makes up a gene.About genetic testing: There are two types of tests used with genetic testing: chromosomal and DNA. Recent advances in these tests have made it more possible to find the genetic cause of CHDs for many patients. Sometimes, however, a genetic change cannot be identified, but the cause can still be genetic.  How to reduce your baby's risk of a congenital heart defect:If you have a CHD, your baby has a higher risk of being born with a CHD. In fact, there is about a 5% chance your child will have a CHD, too. A geneticist or genetic counselor can help you determine if genetic testing might be helpful for you prior to becoming pregnant. See Preconception Counseling for Women with a Congenital Heart Defect for more information. You might be asking yourself:What can I do to lower my baby's chance of being born with a CHD?How might I be able to improve my baby's outcome if he or she has a CHD?  These are important questions to ask your medical care team, but some research suggests taking folate prior to conception and during pregnancy may decrease the risk of a CHD. How a congenital heart defect is diagnosed in an unborn baby:A CHD can be diagnosed very early in pregnancy (around 18 to 20 weeks) via an ultrasound of the baby's heart, called a fetal echocardiogram.  If you have a CHD caused by a genetic change, your maternal-fetal-medicine specialist can perform either an amniocentesis or chorionic villus sampling to determine whether your unborn baby has the same genetic change. Both of these tests are done by inserting a needle into the womb to get a small tissue sample for testing.Additional Information & Resources:Your Family Health History & GeneticsDetecting Genetic AbnormalitiesCongenital AbnormalitiesPlanning A Healthy Pregnancy with a Congenital Heart DefectEthical and Policy Issues in Genetic Testing and Screening of Children (AAP Policy Statement) ​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chph​c.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers. ​ Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
377,18,"2018-04-19 02:48:19",Heart,377,"2018-04-19 03:40:21","Heart Disease: Reduce Your Child's Risk","Heart Disease: Reduce Your Child's Risk Page Content Article BodyHeredity is clearly an important risk factor for conditions such as heart disease, cancer, and diabetes. However, researchers are steadily gathering strong evidence about how diet influence development of diseases. Experts agree that healthy eating habits from an early age can lower the risk of developing several deadly diseases later on. A diet designed to lower the risk of heart disease, diabetes, and other serious diseases is one that benefits the whole family, adults and children alike. Risk Factors for Heart Disease Heart disease is the number one killer of men and women in the United States and most industrialized countries. The chief risk factors are: Smoking High blood pressure Diabetes High blood level of cholesterol Physical inactivity Obesity Family history of early-onset heart disease Following a Heart-Healthy Diet From an Early Age American children and adolescents, on average, eat more saturated fat and have higher blood cholesterol levels than young people their age in most other developed countries. The rate of heart disease tends to keep pace with cholesterol levels. One study found early signs of hardening of the arteries (atherosclerosis) in 7% of children between ages 10 and 15 years, and the rate was twice as high between ages 15 and 20. According to the American Heart Association, a heart-healthy diet from an early age lowers cholesterol and if followed through adolescence and beyond, should reduce the risk of coronary artery disease in adulthood. All children older than 2 years should follow a heart-healthy diet, including low-fat dairy products. For children between the ages of 12 months and 2 years with a family history of obesity, abnormal blood fats, or cardiovascular disease, reduced-fat milk should be considered. Is There a Family History? When you and your children first saw your pediatrician, you were probably asked if there was a history of heart or vascular disease in your family. If your children were young, their grandparents were probably relatively young as well and may not have had a heart attack or stroke (even though they may have been headed for one). If heart disease in the grandparents becomes apparent later on, be sure to bring it to your pediatrician’s attention at the next checkup. Cholesterol Testing for Adopted Children  Complete biological family medical histories are not usually available to adopted children and their parents, even for those adopted in open proceedings. To prevent the development of diseases linked to high blood cholesterol levels, adopted children should be screened periodically for blood lipid (fat) levels throughout childhood. Additional Information  Healthy Active Living for Families The 5 Food Groups: Sample Choices Overcoming Obstacles to Physical Activity What About Fat and Cholesterol? Your Family Health History & Genetics  Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
378,18,"2018-04-19 02:48:19",Heart,378,"2018-04-19 03:40:27","Heart Murmur","Heart Murmur Page Content Article BodyWhat is a heart murmur? Technically, a heart murmur is simply a noise heard between the beats of the heart. When a doctor listens to the heart, she hears a sound something like lub-dub, lub-dub, lub-dub. Most often, the period between the lub and the dub and between the dub and the lub is silent. If there is any sound during this period, it is called a murmur. Although the word is unsettling, murmurs are extremely common, and usually normal (that is, the sounds are causes by a healthy heart pumping blood normally). ""Innocent"" murmurs In preschool and school-age children, heart murmurs are almost always not a concern; the children require no special care, and the sound eventually disappears. These children have ""normal"" or so-called functional or innocent heart murmurs. If your child has such a murmur, it probably will be discovered between the ages of one and five during a routine examination. The doctor then will listen carefully to determine if this is a “normal” heart murmur or one that might indicate a problem. Usually, just by listening to its sound, the pediatrician will be able to tell if a murmur is innocent (normal). If necessary, she will consult a pediatric cardiologist to be certain, but additional tests are usually not necessary. On rare occasions, a pediatrician will hear a murmur that sounds abnormal enough to indicate that something might be wrong with the heart. If the doctor suspects this, your child will be referred to a pediatric cardiologist to enable a precise diagnosis to be made. Heart murmurs and infants When do heart murmurs become a concern? When they occur very early at birth or during the first six months of life. These murmurs are not functional or innocent, and most likely they will require the attention of a pediatric cardiologist immediately. They may be due to abnormal connections between the pumping chambers (septal defects) or the major blood vessels coming from the heart (e.g., transposition of vessels). Your infant will be observed for changes in skin color (turning blue), as well as breathing or feeding difficulties. He also may undergo additional tests, such as a chest X-ray, electrocardiogram (ECG), and an echocardiogram. This echocardiogram creates a picture of the inside of the heart by using sound waves. If all of these tests prove normal, then it is safe to conclude that the baby has an innocent murmur, but the cardiologist and pediatrician may want to see him again to be absolutely certain. The cardiologist and pediatrician together will make a decision as to next steps depending on the results of these tests. When a specific condition called patent ductus arteriosus (PDA) occurs, it is often detected shortly after birth, most commonly in premature babies. It is a potentially serious condition in which blood circulates abnormally between two of the major arteries near the heart, due to the failure of a blood vessel (the ductus arteriosis) between these arteries to properly close. In most cases, the only symptom of PDA is a heart murmur until the ductus closes on its own shortly after birth, which often happens in otherwise healthy, full-term newborns. Sometimes, especially in premature babies, it may not close on its own, or it may be large and permit too much blood to pass through the lungs, which can place extra strain on the heart, forcing it to work harder and causing a rise in blood pressure in the arteries of the lungs. If this is the case, a medication or, rarely, surgery may be needed to help close the PDA. Treatment Innocent heart murmurs  are normal and therefore require no treatment. Children with these innocent heart murmers do not need repeated evaluation or long-term follow-up care from cardiologist, nor do they require restrictions on sports or other physical activities. Innocent heart murmurs generally disappear by midadolescence. Cardiologists don’t know why they go away, any more than we know why they appear in the first place. In the meantime, don’t be discouraged if the murmur is softer on one visit to the pediatrician and loud again on the next. This may simply mean that your child’s heart is beating at a slightly different rate each time. Most likely the murmur will go away eventually. Patent ductus arteriosus is a selfcorrecting problem in some cases, or medications can be used to close a PDA. But if the ductus arteriosus remains open, it may need to be corrected surgically or with a catheter. If other, more serious, heart conditions are diagnosed from birth or shortly thereafter, and the evaluation reveals more serious defects, the pediatric cardiologist and pediatrician will consult a pediatric cardiac surgeon at a regional Pediatric Cardiac Center where complete pediatric cardiac diagnostic and intervention capabilities exist. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
379,18,"2018-04-19 02:48:19",Heart,379,"2018-04-19 03:40:32","Irregular Heartbeat (Arrhythmia)","Irregular Heartbeat (Arrhythmia) Page Content Article BodyMy child's heart seems to beat very fast. Does she have an irregular heartbeat? Your child's heart rate normally will vary to some degree. Fever, crying, exercise, or other vigorous activity makes any heart beat faster. And the younger the child, the faster the normal heart rate will be. As your child gets older, her heart rate will slow down. A resting heart rate of 130 to 150 beats per minute is normal for a newborn infant, but it is too fast for a six-year-old child at rest. In a very athletic teenager, a resting heart rate of 50 to 60 beats per minute may be normal. The heart’s regular rhythm or beat is maintained by a small electrical circuit that runs through nerves in the walls of the heart. When the circuit is working properly, the heartbeat is quite regular; but when there’s a problem in the circuit, an irregular heartbeat, or arrhythmia, can occur. Some children are born with abnormalities in this heart circuitry, but arrhythmias also can be caused by infections or chemical imbalances in the blood. Even in healthy children, there can be other variations in the rhythm of the heartbeat, including changes that occur just as a result of breathing. Such a fluctuation is called sinus arrhythmia, and requires no special evaluation or treatment because it is normal. So-called premature heartbeats are another form of irregular rhythm that requires no treatment. If these occur in your child, she might say that her heart “skipped a beat” or did a “flip-flop.” Usually these symptoms do not indicate the presence of significant heart disease. If your pediatrician says that your child has a true arrhythmia, it could mean that her heart beats faster than normal (tachycardia), very fast (flutter), fast and with no regularity (fibrillation), slower than normal (bradycardia), or that it has isolated early beats (premature beats). While true arrhythmias are not very common, when they do occur they can be serious. On rare occasions they can cause fainting or even heart failure. Fortunately, they can be treated successfully so it’s important to detect arrhythmias as early as possible. Signs and symptoms If your child has a true arrhythmia, your pediatrician probably will discover it during a routine visit. But should you notice any of the following warning signs between pediatric visits, notify your doctor immediately.  Your infant suddenly becomes pale and listless; her body feels limp.  Your child complains of her “heart beating fast,” when she’s not exercising.  She tells you she feels uncomfortable, weak, or dizzy. She blacks out or faints. Diagnosis It's unlikely that your child will ever experience any of these symptoms, but if she does, your pediatrician will perform additional tests and perhaps consult with a pediatric cardiologist. In the process the doctors may do an electrocardiogram (ECG), to better distinguish a normal sinus arrhythmia from a true arrhythmia. An ECG is a tape recording of the electrical impulses that make the heart beat, and it will allow the doctor to observe any irregularities more closely. Sometimes your child's unusual heartbeats may occur at unpredictable times, often not when the ECG is being taken. In that case the cardiologist may suggest that your child carry a small portable tape recorder that continuously records her heartbeat over a one- to two-day period. During this time you'll be asked to keep a log of your child's activities and symptoms. Correlating the ECG with your observations will permit a diagnosis to be made. For example, if your child feels her heart ""flutter"" and becomes dizzy at 2:15 P.M. and the ECG shows her heart suddenly beating faster at the same time, the diagnosis of tachycardia will probably be established. Occasionally irregular heartbeats will occur only during exercise. If that's the case with your child, the cardiologist may have your youngster ride a stationary bicycle or run on a treadmill while her heartbeat is being recorded. When your child is old enough to participate in sports, ask your pediatrician if any special tests or restrictions are necessary. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
380,18,"2018-04-19 02:48:19",Heart,380,"2018-04-19 03:40:37","Kawasaki Disease in Infants & Young Children","Kawasaki Disease in Infants & Young Children Page Content​​Kawasaki Disease is the leading cause of acquired heart disease in infants and young children in the United States. The condition causes inflammation in the blood vessels, and the symptoms can be severe. Children develop high fever for several days, rash, swollen neck glands, swollen hands and feet, and red eyes, lips, and tongue. Early on, Kawasaki Disease can affect the function of the heart muscle or the heart valves. If it is recognized and treated early, children can begin to feel better in a few days with a low likelihood of long-term heart issues.Fast Facts: 80% to 90% of Kawasaki Disease cases occur in children under age 5 and older than 6 months.  Kawasaki Disease is not contagious. It does not spread among family members or children in child care centers. Kawasaki Disease occurs more frequently in those of Asian ancestry. The cause of Kawasaki Disease is not known, but it is thought to be a reaction by the body's immune system. Signs & Symptoms:  Kawasaki Disease begins with a high fever (>102 degrees F) for at least five days, along with other signs and symptoms. Rash all over the body but more severe in the diaper area. Red, bloodshot eyes without any pus, drainage, or crusting.Tender, swollen gland (lymph node) on one side of the neck.Swollen hands and feet with redness on the palms of the hands and the soles of the feet.Very red, swollen, and cracked lips; strawberry-like tongue with rough, red spots.Significant irritability and fussiness. Peeling fingers and toes (typically 2 to 3 weeks after the beginning of fever).Note: The following key signs and symptoms may not be present at the same time. In some very young infants, only a few of these actually develop. Other non-specific symptoms may also be present, such as vomiting, diarrhea, stomachache, cough, runny nose, headache, or pain or swelling of the joints. When to call the doctor:If your child has a fever for 4 to 5 days with some of the key signs and symptoms above, ask your doctor whether he or she could have Kawasaki Disease. It can be challenging to diagnose, so your child may have to be examined several times. See When to Call the Pediatrician: Fever for more information specific to fevers.  Diagnosis:  There is no specific, single test to diagnose Kawasaki Disease. If Kawasaki Disease is suspected, however, your doctor may order tests to monitor heart function (an echocardiogram) and might take blood and urine samples. In addition, your doctor may refer you to a pediatric specialist in infectious disease, rheumatology or cardiology for assistance in diagnosis and treatment. Complications if left untreated: If Kawasaki Disease is left untreated, it can lead to serious complications such as inflammation of the blood vessels. This can be particularly dangerous, because it can affect the coronary arteries—the blood vessels that supply blood to the heart. Aneurysms can also develop.An aneurysm is a ballooning out of a damaged and weakened blood vessel wall. Fortunately, treatment within the first 10 days of illness significantly decreases the risk for aneurysms to develop. Therefore, it is extremely important that a diagnosis is made by 10th day of the illness. Treatment should begin as soon as possible. Treatment for Kawasaki Disease:Children diagnosed with Kawasaki Disease are admitted to the hospital. The medication used to treat Kawasaki Disease in the hospital is called gamma globulin (IVIG). IVIG is given through an IV over 8 to 12 hours. Children may be given aspirin, as well, to lower the risk of heart problems. Children stay in the hospital for at least 24 hours after completing the IVIG dose to make sure the fever does not return and other symptoms are improving. Additional treatments may be necessary if a child does not respond well to the single dose of IVIG, the fever returns, or there are abnormal findings on the first echocardiogram. Another dose of IVIG or other medications that fight inflammation such as steroids, infliximab, or etanercept may be recommended. Pediatric specialists in rheumatology, infectious disease, or cardiology may be consulted in this situation.What to expect after hospital discharge: Children treated for Kawasaki Disease are sent home from the hospital on a low dose of aspirin to take by mouth every day for 6 to 8 weeks. As they recover, it is not uncommon for these children to be extra tired or seem ""off"" for several weeks. Rest is very important. Peeling of the hands and feet is expected and is not cause for alarm.Call your doctor right away if your child develops a fever or any of Kawasaki Disease's signs or symptoms return. Further evaluation is needed. Your child may need to be readmitted to the hospital. Follow-up Care: It is very important to closely monitor children who have had Kawasaki Disease for improvement and to check for the development of coronary aneurysms. Aneurysms most often form after the first couple of weeks of illness. Therefore, children should be scheduled for an echocardiogram and a check-up at 2 weeks and again at 6 to 8 weeks after their fever first started. More frequent follow up and echocardiograms will be necessary if there are abnormal findings on any of the echocardiograms.Note: Live viral vaccines should be postponed at least 11 months after IVIG, because IVIG may render the vaccines in-effective. This includes the MMR (measles, mumps, rubella) and the Varicella (chicken pox) vaccines. Children over 6 months of age should receive the inactivated influenza (flu) vaccine injection. Long-term follow-up:Children treated for Kawasaki Disease who do not develop aneurysms have an excellent long-term outcome. However, it is important for them to follow a heart healthy diet and lifestyle. Cholesterol levels should be checked every 5 years. Children who do have coronary aneurysms should be under the care of a pediatric cardiologist as they grow and will require special long-term care and follow-up. Additional Information & Resources:Fever and Your BabyHospital Care Coverage: Information for ParentsKawasaki Disease (CDC.gov)Kawasaki Disease Foundation Article Body Last Updated 1/20/2017 Source Section on Cardiology ＆ Cardiac Surgery (Copyright © 2017 American Academy of Pediatrics)"
381,18,"2018-04-19 02:48:19",Heart,381,"2018-04-19 03:40:41","Parenting with a Congenital Heart Defect: Why Prioritizing Your Own Health is Important","Parenting with a Congenital Heart Defect: Why Prioritizing Your Own Health is Important Page Content​​​If you are a parent who lives with a congenital heart defect (CHD), it can be challenging to balance the day-to-day demands of being a mom or dad while living with and caring for your own health.Who to Put First? It may be difficult some days to figure out who to put first – your children or yourself. When it is hard to find the energy to even get out of bed, it is important to take care of your own physical and emotional needs first. As a parent, this may not sound ""right,"" but the best gift you can give your child is to also care for yourself.A CHD can be unpredictable, as can your child's needs. Plan ahead. Ask for help. When a CHD overrules parenthood, call friends, family members or a sitter to help. Parenting changes with older children, but you still need to be okay with reaching out to others. Find time to relax. Whether visiting with friends, seeing a movie, meditating, or just reading, it is essential to make relaxation a priority. Lower your expectations. Your parenting style may be different from your sister's or your friend's, but that does not mean you are not a good parent. Lowering your expectations will help make meeting the challenges of parenting with a CHD seem easier. Planning for the FutureEvery person with a CHD should have a living will. It not only notifies your family members about your wishes, but it also guides them in decision making if you are unable to speak for yourself. Once you have a living will, be sure to: Store it in a safe place in your home and tell your family members where it is located. This is not a document to keep in the bank safety deposit box. It should be located in a secure but easily accessible spot in your home. Talk to your family about the instructions included in your living will. Family members are more accepting of a loved one's wishes if they are aware of what those are ahead of time.  Bring it to the hospital if you are admitted. Living wills are now required by hospitals so be sure to bring it with you if you are being admitted to the hospital. Additional Information from HealthyChildren.org:How Taking Care of Yourself Makes You a Better MomWhen Things Aren't Perfect: Caring for Yourself & Your ChildrenThe Greatest Gift You Can Give Your Child (Video)  ​ Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by ​a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers. Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
382,18,"2018-04-19 02:48:19",Heart,382,"2018-04-19 03:40:47","Pediatric Cardiomyopathy","Pediatric Cardiomyopathy Page Content​​​What is cardiomyopathy?Cardiomyopathy is a chronic heart condition that involves the deterioration of the heart muscle (myocardium). The heart muscle becomes abnormally enlarged, thickened and or stiffened. Eventually the heart is unable to pump effectively and cannot supply the body with enough blood to function. In severe cases, cardiomyopathy can lead to heart failure or sudden death. There are 5 forms of cardiomyopathy:Dilated cardiomyopathy (DCM)Hypertrophic cardiomyopathy (HCM)Restrictive cardiomyopathy (RCM)Arrhythmogenic right ventricular cardiomyopathy (ARCM)Left ventricular non-compaction cardiomyopathy (LVNC)Who gets cardiomyopathy?Cardiomyopathy predominantly affects adults, but in rare instances affects infants and children. According to the North American Pediatric Cardiomyopathy Registry, one out of 100,000 children in the U.S. is diagnosed with cardiomyopathy each year. However, this is a conservative number because it does not include all types of cardiomyopathies. Cardiomyopathy can occur in any child regardless of age, gender, race or economic background.Causes of cardiomyopathy in children: There are many causes of cardiomyopathy in children, including some that are not fully understood. Common causes include: Inheriting the condition from one or both parentsA viral infectionToxins affecting other organsUsing chemotherapy drugsMetabolic, mitochondrial or systemic diseases in parts of the body other than the heartDespite advances in genetic testing, the exact cause remains unknown in 2/3 diagnosed children.Symptoms of pediatric cardiomyopathy:Occasionally, symptoms of pediatric cardiomyopathy can be mistaken as a cold, flu, asthma, or stomachache. Some affected children have no symptoms while others may experience any of the following symptoms:Shortness of breath or rapid breathing Dizziness and faintingIrregular or rapid heartbeatAbdominal bloating or swellingChest painExtreme fatigueInfants may experience poor weight gain, extreme sleepiness, difficulty feeding or excessive sweating. How is pediatric cardiomyopathy diagnosed? A pediatric cardiologist confirms the diagnosis through an echocardiogram (echo) and electrocardiogram (EKG, or ECG). In some cases, other medical tests are necessary. Genetic testing may be recommended to verify the cause of the disease. Since pediatric cardiomyopathy is rare, it is recommended to locate a children's medical center with a wide range of experience in managing children with cardiomyopathy. Early diagnosis and treatment of the disease is essential to preventing complications and progression to heart failure. Treatment options for cardiomyopathy:There is no cure for cardiomyopathy, but the disease is treatable. Symptoms and complications can be well-controlled by medications, surgery, and implantable devices. The type of cardiomyopathy and its severity determines the treatment plan.  Medication is usually the first treatment option to improve the functioning of the heart. An implantable cardioverter defibrillator (ICD) may be needed to regulate heartbeat in children with irregular heart rhythms (arrhythmia).  A surgical procedure called a myectomy may relieve some symptoms in children with HCM. A heart transplant may be necessary if medical management is ineffective in controlling symptoms and preventing heart failure.Genetic considerations: Cardiomyopathy is often genetic, so it is important to assess a family's inheritance risk and discuss family screening. A pediatric cardiologist and a pediatric geneticist should work together to form a screening plan and discuss genetic testing options.How does the diagnosis impact a child's lifestyle? Although cardiomyopathy is a chronic condition, many children with cardiomyopathy lead a relatively normal life with few limitations. A diagnosis will likely involve more visits to the cardiologist and taking daily medications. Other adjustments may include restriction from competitive and contact sports, diet changes, and school accommodations.About sudden cardiac arrest:Often underdiagnosed, cardiomyopathy is the leading cause of sudden deaths in children under the age of 18. Because the disease can be present without symptoms, families should be aware of any family members who have heart disease or who died unexpectedly before age 50. Warning signs of sudden cardiac arrest: Recognizing the warning signs of sudden cardiac arrest is also important. If your child experiences any of the following, he or she should see a pediatric cardiologist for an extensive cardiac evaluation:Chest pain or discomfort when being physically activeUnexplained fainting or near faintingExcessive fatigue associated with exerciseUnusually fast heartbeatAdditional Information: Cardiac Conditions in Teens Your Family Health History & Genetics Pediatric Sudden Cardiac Arrest (AAP Policy Statement) Sudden Unexpected Death in Young Athletes: Reconsidering 'Hypertrophic Cardiomyopathy (Review article in Pediatrics) Children's Cardiomyopathy Foundation (CCF) - A non-for-profit organization that offers a variety of educational materials and suppo​rt services​​ Article Body Last Updated 9/26/2016 Source Copyright © 2016 American Academy of Pediatrics ＆ Children’s Cardiomyopathy Foundation"
383,18,"2018-04-19 02:48:19",Heart,383,"2018-04-19 03:40:51","Planning a Healthy Pregnancy with a Congenital Heart Defect","Planning a Healthy Pregnancy with a Congenital Heart Defect Page Content​​Women with a congenital heart defect (CHD) who, after preconception counseling, are able to have a safe or low-risk pregnancy, can take additional steps to plan for a healthy pregnancy.   Your Medical Care Team:Be sure your medical care team has knowledge and experience in treating pregnant women with a CHD. The specific members of this team may differ depending on where you live and what kind of heart condition you have. Congenital Cardiologist: In particular, one who specializes in adults with CHDs.Maternal-Fetal-Medicine Specialist: Also called a ""high-risk obstetrician"" and has experience caring for women with a CHD.  Genetic Counselor: Reviews your medical history and may perform testing to discuss the baby's risk for having a CHD. In general, a baby whose mother or father has a CHD has a small increased chance (about 5%) of being born with a CHD, too.Anesthesiologist: Can talk to you about anesthesia options for labor and delivery. Most women with a CHD can have an epidural during labor and delivery. Vaginal delivery is usually preferred over a caesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.Social Worker: Can help counsel you and your partner on how to handle the stress of managing both your cardiac and pregnancy health. During Your Pregnancy: It is very important to maintain regular care with your obstetrician and congenital cardiologist throughout your pregnancy. Although most women will do well and have healthy pregnancies, women with a CHD do have a higher risk for pregnancy complications, including arrhythmias or irregular heartbeats and premature birth. Your congenital cardiologist ​will determine how often you will require cardiac care during pregnancy. Most women with a CHD see their congenital cardiologist once each trimester, but sometimes more frequent appointments are needed. Your doctor will also determine whether you need cardiac testing during your pregnancy. Most women with a CHD receive an echocardiogram (ultrasound of the heart) early in pregnancy and in the last trimester.As with any pregnant woman, there are ways you can help reduce health risks to your baby before and during pregnancy: Take a daily prenatal vitamin that includes folate.Avoid smoking, alcohol and other drugs (other than medications prescribed by your doctor).Eat a healthy diet.  Exercise.Get enough rest.Labor & Delivery:At some point, you will discuss the type of delivery—vaginal or cesarean section—with your obstetrician. Typically, a vaginal delivery is preferred over a cesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.Regardless of the type of delivery, an anesthesiologist is usually involved to assist with pain control. Most women with a CHD can have an epidural during labor and delivery, but some types of medicine for pain control can affect the heart rate and blood pressure—why meeting with an anesthesiologist before delivery is important!Your Baby's Health:Your baby is at increased risk of being born with a CHD if you or your baby's father have a CHD. Preconception counseling can also assess your baby's CHD risk. Once you're expecting, your doctor will do a special ultrasound of your baby's heart, called a fetal echocardiogram, to see if your baby has any major structural issues to the heart.  Additional Information from HealthyChildren.org:Tests & Screenings During PregnancyLet Baby Set the Delivery Date: Wait until 39 Weeks if You CanParenting with CHD: Why Prioritizing Your Own Health is Important​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​​ Article Body​​ Last Updated 10/28/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
384,18,"2018-04-19 02:48:19",Heart,384,"2018-04-19 03:40:57","Preconception Counseling for Women with a Congenital Heart Defect","Preconception Counseling for Women with a Congenital Heart Defect Page Content​​Even though pregnancy and childbirth stress the heart, most women with a congenital heart defect (CHD) are able to have healthy pregnancies if they choose to do so.Women with a CHD interested in getting pregnant should see a health care professional who specializes in CHDs before becoming pregnant to determine any risks for complications during pregnancy. Preconception counseling—as it is called—can identify any heart problems that may need treatment before conception to assess a baby's risk of being born with a CHD.  Consult with a Specialist: If you have a CHD and are considering becoming pregnant, you should schedule an appointment with a congenital cardiologist. You will need to tell the congenital cardiologist if you have any cardiac symptoms, such as:Shortness of breathFatigue Chest pain Dizziness Heart palpitations (i.e. a feeling like your heart is fluttering or beating too fast or too hard)  Bring a list of all of your medications to a preconception counseling appointment for review. Some medications should not be taken during pregnancy.  Cardiac Testing Prior to Conception: Your doctor will perform special medical tests​​ to see if your heart can handle the increased demands of pregnancy. At a minimum, you will receive an echocardiogram—a type of ultrasound that allows doctors to see a video of the heart.Depending on your symptoms and echocardiogram results, your doctor may perform other tests such as:Holter monitoring: Provides a constant reading of your heartbeat so your doctor can see if you have an unusual heart rhythm.Exercise test: Shows your doctor how your heart handles stress when it needs to work harder.Cardiac MRI: Another type of imaging test that can very accurately show heart size and how well the heart is working. About catheterization: Occasionally, pre-conception ​​test results show that a woman needs a surgery or a catheterization—a nonsurgical way to treat the heart. Catheterization is done by inserting a thin tube into a blood vessel in the neck, arm or leg and threading it to the heart. Your doctor may recommend performing surgery or catheterization before pregnancy to treat damage to a heart valve, narrowing of a vessel, or an aneurysm.Determining Risks for Pregnancy Complications:Your congenital cardiologist will give you a ""risk assessment"" on your likelihood to have cardiac complications during pregnancy. In some cases, your doctor may say your risk of having a dangerous pregnancy is very high. In this situation, discussions with your doctors can help you and your partner better understand these risks as well as consider other options.  Preconception Counseling with Other Specialists:Ask your congenital cardiologist for help finding other medical specialists who can help you make decisions about pregnancy and delivery. Maternal-Fetal-Medicine Specialist: Also called a ""high-risk obstetrician"" and has experience caring for women with a CHD.  Genetic Counselor: Reviews your medical history and may perform testing to determine the baby's risk for having a CHD. In general, a baby whose mother or father has a CHD has a small increased chance (about 5% on average) of being born with a CHD, too.Anesthesiologist: Can talk to you about anesthesia options for labor and delivery. Most women with a CHD can have an epidural during labor and delivery. Vaginal delivery is usually preferred over a cesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.Social Worker: Can help counsel you and your partner on how to handle the stress of managing both your cardiac and pregnancy health. Remember…Parenting can be hard. It is important to talk to your congenital cardiologist about how a CHD will affect your health after delivery, too. See Parenting with CHD: Why Prioritizing Your Own Health is Important. Additional Information from HealthyChildren.org: Your Family Health History & GeneticsPrenatal Genetic CounselingTests & Screenings During Pregnancy​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​ Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
385,18,"2018-04-19 02:48:19",Heart,385,"2018-04-19 03:41:02","Reproductive Health in Young Women with Congenital Heart Defects","Reproductive Health in Young Women with Congenital Heart Defects Page Content​​​A congenital heart defect (CHD) is the most common type of birth defect. Due to advances in medical and surgical therapies, more than 90% of infants born with a CHD will live to see their 18th birthday. As dreams of a full and rich adult life—including a career and family—frequently become reality, adolescents and adults should receive specialized cardiology care throughout their lifetime. The impact of a CHD and its interaction with typical conditions of adulthood such as pregnancy, diabetes, and hypertension must be considered as women living with CHD age. ​​​""Young women living with a CHD can expect better outcomes if they partner with their health care team when making health decisions, especially when it comes to reproductive health,"" said Elyse Foster, M.D., a cardiologist at the University of California, San Francisco, and a member of the Congenital Heart Public Health Consortium (CHP​HC). Anyone who has a heart murmur or had heart surgery as a child should be evaluated by a congenital cardiologist as an adult. Women living with a CHD, specifically, can make informed choices and decrease their chances of a high-risk birth when they work with their health care team. While the overall risk of complications during pregnancy is relatively low, women with a CHD are still eight times as likely to experience cardiovascular complications during pregnancy. Reproductive health considerations should start even before a young woman is ready to start a family. These topics should include contraception, the decision to carry a pregnancy, and the challenges of parenting with a CHD. See the articles below for more information on each subject. Birth Control for Young Women with a CHD Preconception Counseling for Women with a CHDPlanning a Healthy Pregnancy with a CHDGenetics and CHDsParenting with a CHD: Why Prioritizing Your Own Health Is Important​""Guidelines and recommendations for care are available for the management of adult patients with congenital heart defects,"" said Michelle Gurvitz, M.D., a cardiologist at Boston Children's Hospital and a member of the CHPHC. ""However, even with the availability of this information, too great a number of patients fall through the cracks in the system."" Dr. Gurvitz advocates for a team-based approach to care for her adult patients, including congenital cardiology, primary care and other specialties as needed—including obstetrics, gynecology and psychology. Additional information regarding congenital heart defects and lifelong cardiac care is available at the CHPHC website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers. Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
386,18,"2018-04-19 02:48:19",Heart,386,"2018-04-19 03:41:07","Screening & Treating Kids for High Blood Pressure: AAP Report Explained","Screening & Treating Kids for High Blood Pressure: AAP Report Explained Page Content​We usually think of high blood pressure—also known as hypertension—as a problem that affects adults. But, in fact, the condition can be present at any age. An estimated 3.5% of all children and teens in the United States have high blood pressure, however, the condition often goes undetected and untreated.Early Detection is KeyIf high blood pressure isn't identified at a young age, it could go undiagnosed for years—eventually leading to organ damage and other health problems, like coronary artery disease, in adulthood.The American Academy of Pediatrics (AAP) report, Clinical Practice Guidelines for the Screening and Management of High Blood Pressure in Children and Adolescents, gives pediatricians a simpler screening table to follow that identifies blood pressures needing further evaluation.How blood pressure is measured?The term blood pressure actually refers to two separate measurements:Systolic blood pressure is the highest pressure reached in the arteries as the heart pumps blood out for circulation through the body.Diastolic blood pressure is the much lower pressure that occurs in the arteries when the heart relaxes to take blood in between beats.If either or both measurements are above the range found in healthy people of the same age and sex, it's called hypertension.Screening Kids for High Blood Pressure  It's a difficult diagnosis in kids since blood pressure can be affected by many factors, such as height, age and sex. The AAP and the National Heart, Lung and Blood Institute both recommend that children have yearly screenings for high blood pressure, starting at age 3, at their annual well-child visits. If your child's blood pressure is high, he or she will typically be asked to come back a week later to see if the high readings persist. If your child has elevated readings in three consecutive visits, he or she should have an evaluation for the cause of hypertension and risk of organ injury.Infants who were preterm, or of low birth weight, who had a difficult or long hospital stay may need blood pressure screenings sooner than age 3. Children who have congenital heart disease, who are receiving medications that might increase blood pressure, or who have other medical conditions may also be at a greater risk of high blood pressure.Tip for parents: Remember to ask your pediatrician if he or she measured your child's blood pressure, and if so, if it was a concerning reading.What are the Causes?High blood pressure in children is almost always asymptomatic—that is, without any symptoms or noticeable discomfort.In many cases, high blood pressure seems to develop with age. As a result, a child may show no signs of high blood pressure as an infant, but may develop the condition as he or she grows. By age 7, more than 50% of hypertension is due to obesity; this rises to 85-95% by the teenage years. Thus, good eating habits (without overeating and emphasizing foods low in sodium, low in added sugar and high in fruits and vegetables) and plenty of physical activity are important throughout the early years of childhood (and for the rest of life).When high blood pressure becomes severe in children, it may be a symptom of another serious problem, such as kidney disease or abnormalities of the heart or of the nervous or endocrine (gland) system.Diagnosing High Blood Pressure in Children​If your child's blood pressure is high, your pediatrician may recommend tests to see if there is an underlying medical problem causing it. These tests include studies of the urine and blood. Sometimes, ultrasounds are used to examine the heart or the kidneys. If no medical problem can be found, your child will be diagnosed with essential hypertension—the word essential refers only to the fact that no cause could be found.About essential hypertension: In most children and adolescents, no specific cause is found for hypertension. Doctors take into account the child's medical history (other diagnoses like kidney disease), family history (heritability of hypertension is about 50%),  risk factors such as low weight at birth, and whether the child is currently overweight.Management & Treatment The first-line treatment for high blood pressure in children remains lifestyle changes.If obesity is a possible cause, the first step will be to have your child lose weight. This will need to be very closely monitored by your pediatrician. Not only will weight loss lower blood pressure, it can provide many other health benefits as well.Limit the salt in your child's diet. Giving up the use of table salt and restricting salty foods can lower blood pressure in some patients. Common sources of salty foods include bread, deli meats, pizza, and foods prepared outside the home.   Use caution when shopping for packaged foods. Most canned and processed foods contain a great deal of salt, so check labels carefully to make sure the items have little or no salt added.Help your child get more aerobic exercise. Aerobic physical activity can lower blood pressure, because of its effect on blood vessels and the heart—even when patients do not lose weight. The AAP recommends 60 minutes of physical activity each day. About blood pressure-lowering medications: If lifestyle changes do not work, or if the blood pressure is very high, a more aggressive approach is needed. The AAP guidelines recommend pediatricians start blood pressure-lowering medications if lifestyle changes fail to reduce your child's blood pressure, or your child has another condition like diabetes or kidney disease. There are a variety of anti-hypertensive medications that have been tested and proven to be safe in the short- and long-term. The number of children who will end up with prescriptions for anti-hypertensive medications is small, about 1% or less. Long-term care: Once your pediatrician knows your child has high blood pressure, he or she will want to check it frequently to make sure the hypertension is not becoming more severe. Depending on how high the blood pressure is, your pediatrician may refer your child to a specialist—usually a pediatric nephrologist (kidney specialist) or pediatric cardiologist (heart specialist). Additional Information & Resources:5 Ways to Protect Your Kids Against Metabolic Syndrome: AAP Report ExplainedHeart Disease: Reduce Your Child's RiskHow to Reduce Fat and Cho­lesterol in Your Child's DietEnergy In: Recommended Food & Drink Amounts for ChildrenEnergy Out: Daily Physical Activity RecommendationsAthletic Participation by Children and Adolescents Who Have Systemic Hypertension (AAP Policy Statement) Article Body Last Updated 8/21/2017 Source American Academy of Pediatrics (Copyright © 2017)"
387,19,"2018-04-19 02:48:19",Infections,372,"2018-04-19 03:39:31","Birth Control for Young Women with a Congenital Heart Defect","Birth Control for Young Women with a Congenital Heart Defect Page Content​Understanding the risks and benefits of different birth control methods is important for all women. For women with a congenital heart defect (CHD), choosing the right birth control is critical to maintaining a healthy heart.  Questions to Ask Yourself:Selecting birth control when you have a CHD requires you to think about all aspects of your life.  Some typical questions might be:Do I ever want to become pregnant? If so, when might that be? Will pregnancy be too risky with my heart condition?  Some women with a CHD have a very high risk for medical complications if they become pregnant. If this is you, it is important to use a very effective form of birth control or to consider permanent sterilization.If pregnancy could be dangerous to your health but you would like to have a family, talk to your doctor about other options, such as adoption or surrogacy. Deciding not to have children is a perfectly acceptable option, too, if that is what you choose.Types of Birth Control:Women with a CHD who are able to have a safe or low risk pregnancy but are not ready to become pregnant yet have many options for birth control. Some methods are more effective than others and some also last longer than others. Some methods contain the hormones estrogen and/or progesterone (e.g. oral medications, skin patches, vaginal rings, implants).Some forms of birth control use a ""barrier"" method to block sperm from entering the uterus (e.g. condoms, copper intrauterine devices or IUDs, diaphragms).Benefits & Risks of Birth Control Methods:There are different risks and success rates for the various forms of birth control.Condoms ​have little physical risk to women. They are also highly effective at protecting against sexually transmitted diseases. However, they do not always work well at preventing pregnancy. In fact, they have a failure rate as high as 30%.Birth control pills are usually reliable at preventing pregnancy. However, some forms bith control pills contain estrogen which can increase the risk of stroke and other medical complications related to the increased risk of blood clots. Estrogen is not recommended if you have a CHD and are at increased risk of forming blood clots, especially if you have an artificial heart valve or have had a Fontan operation.Progesterone-only birth control methods have a lower risk of blood clots. Progesterone can be taken as a pill, placed as an implant under the skin, given as monthly injections or used in an IUD. A progesterone pill must be taken at the same time every day. Progesterone forms of birth control are often good choices if you have a CHD. They can be highly effective when they are used the right way. Progesterone IUD is a very effective method if you do not want to become pregnant for at least a few years.   Two forms of birth control are recommended if you are sure you never want to become pregnant or are at very high risk for a dangerous pregnancy. You may consider a tubal ligation or other permanent form of birth control, as well. If you have a long-term male partner, you may consider asking him to have a vasectomy.   Talk to your gynecologist about which form of birth control is best for you based on the recommendations of your congenital cardiologist.  ​​Additional Information & Resources: Sexually Transmitted Infections PreventionSexuality Education for Children and Adolescents (AAP Clinical Report)Birth Control Methods Fact Sheet (WomensHealth.gov)​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​ Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
388,19,"2018-04-19 02:48:19",Infections,373,"2018-04-19 03:39:35","Cardiac Conditions in Teens","Cardiac Conditions in Teens Page Content Article BodyTeenagers frequently experience chest pain. Rarely, though, is the symptom related to the heart. Nevertheless, such complaints should be brought to the attention of your pediatrician, who will diagnose the problem through process of elimination. “Usually, just asking the patient questions points us to the source of the pain,” says Dr. Reginald L. Washington, a pediatric cardiologist from Denver. Among the red flags he looks for are chest pain upon physical exertion and chest pain accompanied by dizziness. “Those situations would warrant further evaluation,” he says, “but most of the time the cause turns out to be anxiety, too much caffeine, asthma, muscle strain or costochondritis.” The latter condition, an inflammation of the chest wall, is treated with rest, over-the counter anti-inflammatory medications and heat. High Blood Pressure (Hypertension) and High Blood Cholesterol (Hypercholesteremia) Doctors once believed that virtually all high blood pressure in youngsters was a complication of another medical condition, such as kidney disease. We now know that even infants can develop primary hypertension, also referred to as essential hypertension. Abnormally elevated levels of the fatlike substance cholesterol in the circulation are also sometimes seen in teenagers. Either problem can pave the way for a future heart attack, cerebral stroke, renal failure, or blindness, among other conditions. Symptoms that Suggest Primary Hypertension or Hypercholesteremia Include: Dizziness and/or headache from high blood pressure High cholesterol does not cause symptoms in teenagers How Hypertension and Hypercholesteremia are Diagnosed Diagnostic measures include physical examination and thorough medical history, plus one or more of the following procedures: (1) multiple blood pressure readings (2) cholesterol blood test. In teenagers, an abnormally high blood-pressure measurement calls for a second reading, then several additional readings over the course of other office visits before a definitive diagnosis is made. The first number represents the systolic pressure: the peak pressure within the blood vessels when the heart contracts. The second number expresses the diastolic blood pressure reached when the heart relaxes between beats. If the blood pressure remains elevated, more extensive laboratory tests would be  ordered, along with an electrocardiogram (EKG). Memo to Mom and Dad: Stress can contribute to hypertension. As parents of a teenager, have you had your blood pressure taken lately? How Hypertension and Hypercholesteremia are Treated Improved diet and exercise: Both hypertension and hypercholesteremia are uncommon among teenagers. Often, studying the family tree reveals a genetic thread entwined throughout its branches. About half of all youngsters diagnosed with hypertension and two-thirds of those with high cholesterol have a hereditary predisposition to the disorder. “The rest of the cases are due to poor dietary practices and a lack of physical activity,” says Dr. Washington. “In general, those are the easiest to treat. If they learn to eat healthily and engage in aerobic exercise, almost all of them can get their blood pressure and cholesterol down into a normal range.” Even if your youngster’s blood pressure and cholesterol level are normal, we advise following the sensible eating plan. Getting into the habit of choosing foods that are low in saturated fat, cholesterol and salt may help prevent cardiovascular disease later in life. Drug therapy: Adolescents who fall into the high-risk categories for hypertension or hypercholesteremia may require medication in addition to modifying their diet and lifestyle. Agents typically used to bring down the concentration of cholesterol in the blood include cholestyramine, clofibrate and statins. To lower blood pressure, a pediatrician might prescribe a diuretic in combination with an agent from one of four families: beta-blockers, angiotensinconverting-enzyme inhibitors or ACE inhibitors; calcium-channel blockers; and alpha-beta blockers. Diuretics, also known as “water pills,” act on the kidneys to flush excess water and sodium (salt) from the body. The other medications reduce blood pressure through various mechanisms. Helping Teenagers to Help Themselves Youngsters with or without hypertension or hypercholesteremia should be encouraged to: Maintain a healthy weight. Engage in aerobic exercise for at least thirty minutes per day. Abstain from using tobacco or alcohol. Learn techniques for relieving stress, be it exercise, deep breathing or meditation. Consult the pediatrician if considering taking birth-control pills. Although neither condition is common in healthy teens, oral contraceptives can worsen both high blood pressure and high blood cholesterol.   Mitral Valve Prolapse (MVP) Four flap like valves regulate the flow of blood through the heart’s four chambers. The mitral valve is situated in the left side of the heart, the side that receives freshly oxygenated blood from the lung, then pumps it out to the circulation. Under normal circumstances, the valve opens to let blood pass from the upper left chamber (the left atrium) into the lower left chamber (the left ventricle). Approximately one in eight otherwise healthy adolescents and young adults are found to have mitral valve prolapse. For reasons that remain unclear, one or both flippers billows out (prolapses) into the upper chamber instead of snapping shut. This can produce a clicking sound, audible through the pediatrician's stethoscope. Occasionally, blood may leak backward into the atrium, causing a murmur.  “The sounds usually come and go,” says Dr. Washington. Some youngsters with mitral valve prolapse have both a click and a murmur, while others have no abnormal heart noises at all. Symptoms that Suggest Mitral Valve Prolapse May Include: Abnormal heart murmur Fluttering sensation in the chest, as if the heart were racing or skipping a beat Shortness of breath Headache Sharp, fleeting chest pain Nineteen out of twenty people with mitral valve prolapse do not exhibit any symptoms; the condition is discovered during a routine physical. How Mitral Valve Prolapse is Diagnosed Physical examination and thorough medical history, plus one or more of the following procedures: Stethoscopic exam echocardiogram chest X ray How Mitral Valve Prolapse is Treated “The vast majority of people with mitral valve prolapse can go about their lives without having to worry about the condition or restrict athletic activities,” explains Dr. Washington. Under certain circumstances, however, a leaky mitral valve can become infected. To reduce the risk of endocarditis, rare though it may be, the current recommendation is for antibiotics to be taken just prior to dental appointments and surgical procedures. Helping Teenagers to Help Themselves Reducing caffeine consumption can help alleviate heart palpitations. Remember that caffeine is present not only in coffee but in soda, chocolate and tea. Heart Murmur: Language of the Heart “A heart murmur,” explains Dr. Washington, “is merely the sound of the heart vibrating slightly or valves opening and closing as blood flows through it. There are probably fifty different types, each with its own distinctive sound. Most of them,” he emphasizes, “are perfectly normal.” As many as four in five young people have these “innocent” murmurs now and then. Unless the murmur occurs during a doctor’s visit, it generally goes undetected. An abnormal murmur, which a pediatrician can identify with a stethoscope, indicates a heart condition that may require further diagnostic testing, possibly by a pediatric cardiologist. Possible causes include infections of the heart (endocarditis, myocarditis), faulty valves and cardiac defects that had been present since birth. Normal heart murmurs don’t call for limits on activities. With abnormal murmurs, says Dr. Washington, “the underlying cause will determine whether restrictions are necessary.” Last Updated 11/21/2015 Source Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)"
389,19,"2018-04-19 02:48:19",Infections,374,"2018-04-19 03:40:04","Challenges Faced by Parents of Children with Congenital Heart Disease","Challenges Faced by Parents of Children with Congenital Heart Disease Page Content​​​The first thing most parents want to know about their unborn baby is whether the baby is healthy. From the moment parents hear the words, ""Your child has a heart defect,"" they are thrust into a world they were not expecting. Even before the child is born, the joy of giving birth is often coupled with so many unique and complicated feelings—ranging from fear, guilt, sadness, shame, and confusion. Many feel ashamed of these feelings and try to suppress them, but it is important to remember these feelings are common and expected.About Congenital Heart DefectsCongenital Heart Disease (CHD) is the most common type of birth defect affecting 8 out of every 1,000 newborns.  Each year, about 35,000 babies in the Unites States are diagnosed with CHD. Nearly 25% of those are critical congenital heart defects—ones that require surgery or other interventions within the first year of life to survive. Parents of these children often sit by their child's side in the hospital hoping and praying their child survives. As a result of dramatic advances in the medical and surgical management of CHD, 85% of infants with CHD are now expected to survive to adulthood, and CHD is regarded as a chronic disease rather than a terminal one. However, survival rates for children with critical congenital heart defects is lower; they often need specialized medical care throughout their lifetime.  Understanding Unique Parenting ChallengesAll parents are caregivers, but parents of children with CHD have extra challenges. Learning ""normal"" and more specialized parenting skills:Aside from the typical stresses and adjustments new parents face, in most cases, parents who have a baby with CHD are also struggling to care for a baby who may have spent months in the Neonatal Intensive Care Unit (NICU) and may have tubes or attachments to his or her tiny body. When babies have open-heart surgeries, their ability to learn to eat can be compromised. Some babies have to be fed through a feeding tube. In addition to feeding issues, many children with CHD have trouble gaining weight and must go on special high-calorie diets. Becoming an expert and advocate. Knowledge is power. Parents often immerse themselves into learning as much as they possibly can about their child's diagnosis, medication, and treatment plan. It is important to avoid ""internet overload"" by sticking to reputable websites. See the additional resources at the end of this article.  Making changes to safeguard their child's health:Infants and children with CHD have weaker immune systems than the average child. They can end up in the hospital for illnesses that others recover from on their own. Thus, many parents take extra precautions to try to keep their child healthy. This may mean having serious talks with friends and family about getting their annual flu shot and a Tdap shot to prevent whooping cough. See How to Cocoon a Newborn: Only an E-Mail Away! for more information and tips. As their child grows, parents must strike a balance between letting their child live ""normally"" and protecting them. Walking the line between healthy limits and over-protectiveness is an ongoing concern. Struggling with the financial component of care: For a child with CHD, surgical costs can be astronomical, even with health insurance. The costs of medicines and doctor appointments add up quickly, too. Many children with CHD are on multiple medications, some taken several times a day. It's not unusual for children who've had open-heart surgery to come home on six or more different medications. Caring for their other children:If there are siblings in the family, parents must also take their needs into consideration. Young children, especially, may have fears and anxieties about their brother or sister's condition that they aren't voicing. It is important to spend one-on-one time with each child and time together as a family that isn't focused on the CHD.Educating the school and others: Often, sending a child with CHD to preschool or school, or even having siblings in school, can pose challenges for parents. Again, avoiding major illnesses is a concern. Educating school staff about CHD and their child's limitations can also be difficult. Sometimes, parents get everyone together who will be working with their child, so that they all understand the condition or defect. Living with persistent uncertainty:Even if their child doesn't need any more procedures, there will always be doctor appointments that will inevitably dredge up some old memories and new fears. As children grow, it is also natural for parents to feel fear about the inherent risks of CHD and the knowns and unknowns about their child's lifelong care. The journey is never over, so support plays a big role in these parents' lives. Why Support is So ImportantParents need for all kinds of support – informational, emotional, and instrumental – to be able to face the stress of caring for a child with CHD.  Connecting with other parents of children with a CHD:Parents and other family members are encouraged to connect with others who also have a child in their family with a heart defect. Other parents, for example, can provide a credible model of how to cope in a positive way with exceptional life circumstances. Talking to a trained mental health professional: Parents who seek the assistance of mental health professionals typically experience reductions in stress, depression and anxiety, as well as improved sleep and life satisfaction. The Silver Lining Life with a child diagnosed with CHD can be overwhelming, stressful, and in some cases tragic. However, some families have recognized a silver lining in having a family member with a complex medical condition like CHD. For example, siblings can be more resilient—demonstrating increased compassion, a greater sense of wonder and joy, and a greater appreciation for life. Many parents' outlook on life and priorities can change, as well, to appreciate the ""little things in life"" a lot more. Additional Resources: Little Heart Guide: A Parent and Caregiver's Guide (Mended Little Hearts) – Guide for families affected by a CHD from diagnosis throughout the lifespan. Caregiving for Children with a CHD: Three Parents' Perspectives (Mended Little Hearts) - Parents of ""heart children"" to share their experiences. It's My Heart (Children's Heart Foundation) – Provides descriptions of the types of CHDs as well as explanations of the various tests, procedures and treatments.When Your Child has a Heart Defect: Planning Ahead for Lifelong Heart Health (Adult Congenital Heart Association) - Designed to help parents of children born with CHD plan ahead for lifelong heart health. Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​ Article Body Last Updated 5/19/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
390,19,"2018-04-19 02:48:19",Infections,375,"2018-04-19 03:40:09","Common Heart Defects","Common Heart Defects Page Content Article Body​Congenital heart defects are structural problems arising from abnormal formation of the heart or major blood vessels. At least 1% of all live-born infants have a heart defect. The cause of a heart defect is most often unknown. Some defects may be small and may cause your child few problems; others are life-threatening.Types of Congenital Heart DefectsThere are 18 types of congenital heart defects recognized and ​many additional anatomic variations. The more common heart defects are listed below:​ Atrial Septal Defect (ASD)Atrioventricular Canal DefectCoarctation of the Aorta (CoA)Hypoplastic Left Heart Syndrome (HLHS)Pulmonary AtresiaPulmonary Stenosis (PS)Tetralogy of FallotTotal Anomalous Pulmonary Venous Connection (TAPVC)Transposition of the Great ArteriesTricuspid AtresiaTruncus ArteriosusVentricular Septal DefectOutlook for Children Born with a Heart DefectEven if your baby is born with a heart defect, it is very likely nowadays that he or she can live a normal adult life and overcome the problem. The many advances in the diagnosis and treatment have made it possible to correct defects via surgery and heart catheterization. Even the most difficult cases have hope now.The ​​diagnosis and treatment for other heart defects will continue to improve ​with new advancements and ​research. ​Talk with your child's pediatric heart surgeon if you have specific questions about your child's condition, treatment options, and expected outcomes. Additional Information What is a Pediatric Heart Surgeon?Cardiac Conditions in TeensYour Family Health History & Genetics​ Last Updated 11/21/2015 Source Newborn Intensive Care: What Every Parent Needs to Know, 3rd Edition (Copyright © 2010 American Academy of Pediatrics)"
391,19,"2018-04-19 02:48:19",Infections,376,"2018-04-19 03:40:16","Genetics and Congenital Heart Defects","Genetics and Congenital Heart Defects Page Content​​​​A congenital heart defect (CHD) is the most common type of birth defect. It is estimated that 2 to 3 million people in the United States have a CHD.Over the last few decades, treatments for CHDs have improved—meaning more children born with a CHD are growing up to have children of their own. If you have a CHD, you might wonder what the risk is for your child to also have a CHD. You might also wonder whether pregnancy will affect your health. These are very important questions to discuss with your congenital cardiologist and perhaps other specialists, such as a maternal-fetal-medicine specialist and a geneticist or genetic counselor. What causes a congenital heart defect?CHDs are caused by genetics, the environment, or a combination of both. Some known genetic causes include:Chromosome abnormalities: Extra or missing chromosomes.Gene mutation: A change to the DNA sequence or order that makes up a gene.About genetic testing: There are two types of tests used with genetic testing: chromosomal and DNA. Recent advances in these tests have made it more possible to find the genetic cause of CHDs for many patients. Sometimes, however, a genetic change cannot be identified, but the cause can still be genetic.  How to reduce your baby's risk of a congenital heart defect:If you have a CHD, your baby has a higher risk of being born with a CHD. In fact, there is about a 5% chance your child will have a CHD, too. A geneticist or genetic counselor can help you determine if genetic testing might be helpful for you prior to becoming pregnant. See Preconception Counseling for Women with a Congenital Heart Defect for more information. You might be asking yourself:What can I do to lower my baby's chance of being born with a CHD?How might I be able to improve my baby's outcome if he or she has a CHD?  These are important questions to ask your medical care team, but some research suggests taking folate prior to conception and during pregnancy may decrease the risk of a CHD. How a congenital heart defect is diagnosed in an unborn baby:A CHD can be diagnosed very early in pregnancy (around 18 to 20 weeks) via an ultrasound of the baby's heart, called a fetal echocardiogram.  If you have a CHD caused by a genetic change, your maternal-fetal-medicine specialist can perform either an amniocentesis or chorionic villus sampling to determine whether your unborn baby has the same genetic change. Both of these tests are done by inserting a needle into the womb to get a small tissue sample for testing.Additional Information & Resources:Your Family Health History & GeneticsDetecting Genetic AbnormalitiesCongenital AbnormalitiesPlanning A Healthy Pregnancy with a Congenital Heart DefectEthical and Policy Issues in Genetic Testing and Screening of Children (AAP Policy Statement) ​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chph​c.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers. ​ Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
392,19,"2018-04-19 02:48:19",Infections,377,"2018-04-19 03:40:21","Heart Disease: Reduce Your Child's Risk","Heart Disease: Reduce Your Child's Risk Page Content Article BodyHeredity is clearly an important risk factor for conditions such as heart disease, cancer, and diabetes. However, researchers are steadily gathering strong evidence about how diet influence development of diseases. Experts agree that healthy eating habits from an early age can lower the risk of developing several deadly diseases later on. A diet designed to lower the risk of heart disease, diabetes, and other serious diseases is one that benefits the whole family, adults and children alike. Risk Factors for Heart Disease Heart disease is the number one killer of men and women in the United States and most industrialized countries. The chief risk factors are: Smoking High blood pressure Diabetes High blood level of cholesterol Physical inactivity Obesity Family history of early-onset heart disease Following a Heart-Healthy Diet From an Early Age American children and adolescents, on average, eat more saturated fat and have higher blood cholesterol levels than young people their age in most other developed countries. The rate of heart disease tends to keep pace with cholesterol levels. One study found early signs of hardening of the arteries (atherosclerosis) in 7% of children between ages 10 and 15 years, and the rate was twice as high between ages 15 and 20. According to the American Heart Association, a heart-healthy diet from an early age lowers cholesterol and if followed through adolescence and beyond, should reduce the risk of coronary artery disease in adulthood. All children older than 2 years should follow a heart-healthy diet, including low-fat dairy products. For children between the ages of 12 months and 2 years with a family history of obesity, abnormal blood fats, or cardiovascular disease, reduced-fat milk should be considered. Is There a Family History? When you and your children first saw your pediatrician, you were probably asked if there was a history of heart or vascular disease in your family. If your children were young, their grandparents were probably relatively young as well and may not have had a heart attack or stroke (even though they may have been headed for one). If heart disease in the grandparents becomes apparent later on, be sure to bring it to your pediatrician’s attention at the next checkup. Cholesterol Testing for Adopted Children  Complete biological family medical histories are not usually available to adopted children and their parents, even for those adopted in open proceedings. To prevent the development of diseases linked to high blood cholesterol levels, adopted children should be screened periodically for blood lipid (fat) levels throughout childhood. Additional Information  Healthy Active Living for Families The 5 Food Groups: Sample Choices Overcoming Obstacles to Physical Activity What About Fat and Cholesterol? Your Family Health History & Genetics  Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)"
393,19,"2018-04-19 02:48:19",Infections,378,"2018-04-19 03:40:27","Heart Murmur","Heart Murmur Page Content Article BodyWhat is a heart murmur? Technically, a heart murmur is simply a noise heard between the beats of the heart. When a doctor listens to the heart, she hears a sound something like lub-dub, lub-dub, lub-dub. Most often, the period between the lub and the dub and between the dub and the lub is silent. If there is any sound during this period, it is called a murmur. Although the word is unsettling, murmurs are extremely common, and usually normal (that is, the sounds are causes by a healthy heart pumping blood normally). ""Innocent"" murmurs In preschool and school-age children, heart murmurs are almost always not a concern; the children require no special care, and the sound eventually disappears. These children have ""normal"" or so-called functional or innocent heart murmurs. If your child has such a murmur, it probably will be discovered between the ages of one and five during a routine examination. The doctor then will listen carefully to determine if this is a “normal” heart murmur or one that might indicate a problem. Usually, just by listening to its sound, the pediatrician will be able to tell if a murmur is innocent (normal). If necessary, she will consult a pediatric cardiologist to be certain, but additional tests are usually not necessary. On rare occasions, a pediatrician will hear a murmur that sounds abnormal enough to indicate that something might be wrong with the heart. If the doctor suspects this, your child will be referred to a pediatric cardiologist to enable a precise diagnosis to be made. Heart murmurs and infants When do heart murmurs become a concern? When they occur very early at birth or during the first six months of life. These murmurs are not functional or innocent, and most likely they will require the attention of a pediatric cardiologist immediately. They may be due to abnormal connections between the pumping chambers (septal defects) or the major blood vessels coming from the heart (e.g., transposition of vessels). Your infant will be observed for changes in skin color (turning blue), as well as breathing or feeding difficulties. He also may undergo additional tests, such as a chest X-ray, electrocardiogram (ECG), and an echocardiogram. This echocardiogram creates a picture of the inside of the heart by using sound waves. If all of these tests prove normal, then it is safe to conclude that the baby has an innocent murmur, but the cardiologist and pediatrician may want to see him again to be absolutely certain. The cardiologist and pediatrician together will make a decision as to next steps depending on the results of these tests. When a specific condition called patent ductus arteriosus (PDA) occurs, it is often detected shortly after birth, most commonly in premature babies. It is a potentially serious condition in which blood circulates abnormally between two of the major arteries near the heart, due to the failure of a blood vessel (the ductus arteriosis) between these arteries to properly close. In most cases, the only symptom of PDA is a heart murmur until the ductus closes on its own shortly after birth, which often happens in otherwise healthy, full-term newborns. Sometimes, especially in premature babies, it may not close on its own, or it may be large and permit too much blood to pass through the lungs, which can place extra strain on the heart, forcing it to work harder and causing a rise in blood pressure in the arteries of the lungs. If this is the case, a medication or, rarely, surgery may be needed to help close the PDA. Treatment Innocent heart murmurs  are normal and therefore require no treatment. Children with these innocent heart murmers do not need repeated evaluation or long-term follow-up care from cardiologist, nor do they require restrictions on sports or other physical activities. Innocent heart murmurs generally disappear by midadolescence. Cardiologists don’t know why they go away, any more than we know why they appear in the first place. In the meantime, don’t be discouraged if the murmur is softer on one visit to the pediatrician and loud again on the next. This may simply mean that your child’s heart is beating at a slightly different rate each time. Most likely the murmur will go away eventually. Patent ductus arteriosus is a selfcorrecting problem in some cases, or medications can be used to close a PDA. But if the ductus arteriosus remains open, it may need to be corrected surgically or with a catheter. If other, more serious, heart conditions are diagnosed from birth or shortly thereafter, and the evaluation reveals more serious defects, the pediatric cardiologist and pediatrician will consult a pediatric cardiac surgeon at a regional Pediatric Cardiac Center where complete pediatric cardiac diagnostic and intervention capabilities exist. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
394,19,"2018-04-19 02:48:19",Infections,379,"2018-04-19 03:40:32","Irregular Heartbeat (Arrhythmia)","Irregular Heartbeat (Arrhythmia) Page Content Article BodyMy child's heart seems to beat very fast. Does she have an irregular heartbeat? Your child's heart rate normally will vary to some degree. Fever, crying, exercise, or other vigorous activity makes any heart beat faster. And the younger the child, the faster the normal heart rate will be. As your child gets older, her heart rate will slow down. A resting heart rate of 130 to 150 beats per minute is normal for a newborn infant, but it is too fast for a six-year-old child at rest. In a very athletic teenager, a resting heart rate of 50 to 60 beats per minute may be normal. The heart’s regular rhythm or beat is maintained by a small electrical circuit that runs through nerves in the walls of the heart. When the circuit is working properly, the heartbeat is quite regular; but when there’s a problem in the circuit, an irregular heartbeat, or arrhythmia, can occur. Some children are born with abnormalities in this heart circuitry, but arrhythmias also can be caused by infections or chemical imbalances in the blood. Even in healthy children, there can be other variations in the rhythm of the heartbeat, including changes that occur just as a result of breathing. Such a fluctuation is called sinus arrhythmia, and requires no special evaluation or treatment because it is normal. So-called premature heartbeats are another form of irregular rhythm that requires no treatment. If these occur in your child, she might say that her heart “skipped a beat” or did a “flip-flop.” Usually these symptoms do not indicate the presence of significant heart disease. If your pediatrician says that your child has a true arrhythmia, it could mean that her heart beats faster than normal (tachycardia), very fast (flutter), fast and with no regularity (fibrillation), slower than normal (bradycardia), or that it has isolated early beats (premature beats). While true arrhythmias are not very common, when they do occur they can be serious. On rare occasions they can cause fainting or even heart failure. Fortunately, they can be treated successfully so it’s important to detect arrhythmias as early as possible. Signs and symptoms If your child has a true arrhythmia, your pediatrician probably will discover it during a routine visit. But should you notice any of the following warning signs between pediatric visits, notify your doctor immediately.  Your infant suddenly becomes pale and listless; her body feels limp.  Your child complains of her “heart beating fast,” when she’s not exercising.  She tells you she feels uncomfortable, weak, or dizzy. She blacks out or faints. Diagnosis It's unlikely that your child will ever experience any of these symptoms, but if she does, your pediatrician will perform additional tests and perhaps consult with a pediatric cardiologist. In the process the doctors may do an electrocardiogram (ECG), to better distinguish a normal sinus arrhythmia from a true arrhythmia. An ECG is a tape recording of the electrical impulses that make the heart beat, and it will allow the doctor to observe any irregularities more closely. Sometimes your child's unusual heartbeats may occur at unpredictable times, often not when the ECG is being taken. In that case the cardiologist may suggest that your child carry a small portable tape recorder that continuously records her heartbeat over a one- to two-day period. During this time you'll be asked to keep a log of your child's activities and symptoms. Correlating the ECG with your observations will permit a diagnosis to be made. For example, if your child feels her heart ""flutter"" and becomes dizzy at 2:15 P.M. and the ECG shows her heart suddenly beating faster at the same time, the diagnosis of tachycardia will probably be established. Occasionally irregular heartbeats will occur only during exercise. If that's the case with your child, the cardiologist may have your youngster ride a stationary bicycle or run on a treadmill while her heartbeat is being recorded. When your child is old enough to participate in sports, ask your pediatrician if any special tests or restrictions are necessary. Last Updated 11/21/2015 Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)"
395,19,"2018-04-19 02:48:19",Infections,380,"2018-04-19 03:40:37","Kawasaki Disease in Infants & Young Children","Kawasaki Disease in Infants & Young Children Page Content​​Kawasaki Disease is the leading cause of acquired heart disease in infants and young children in the United States. The condition causes inflammation in the blood vessels, and the symptoms can be severe. Children develop high fever for several days, rash, swollen neck glands, swollen hands and feet, and red eyes, lips, and tongue. Early on, Kawasaki Disease can affect the function of the heart muscle or the heart valves. If it is recognized and treated early, children can begin to feel better in a few days with a low likelihood of long-term heart issues.Fast Facts: 80% to 90% of Kawasaki Disease cases occur in children under age 5 and older than 6 months.  Kawasaki Disease is not contagious. It does not spread among family members or children in child care centers. Kawasaki Disease occurs more frequently in those of Asian ancestry. The cause of Kawasaki Disease is not known, but it is thought to be a reaction by the body's immune system. Signs & Symptoms:  Kawasaki Disease begins with a high fever (>102 degrees F) for at least five days, along with other signs and symptoms. Rash all over the body but more severe in the diaper area. Red, bloodshot eyes without any pus, drainage, or crusting.Tender, swollen gland (lymph node) on one side of the neck.Swollen hands and feet with redness on the palms of the hands and the soles of the feet.Very red, swollen, and cracked lips; strawberry-like tongue with rough, red spots.Significant irritability and fussiness. Peeling fingers and toes (typically 2 to 3 weeks after the beginning of fever).Note: The following key signs and symptoms may not be present at the same time. In some very young infants, only a few of these actually develop. Other non-specific symptoms may also be present, such as vomiting, diarrhea, stomachache, cough, runny nose, headache, or pain or swelling of the joints. When to call the doctor:If your child has a fever for 4 to 5 days with some of the key signs and symptoms above, ask your doctor whether he or she could have Kawasaki Disease. It can be challenging to diagnose, so your child may have to be examined several times. See When to Call the Pediatrician: Fever for more information specific to fevers.  Diagnosis:  There is no specific, single test to diagnose Kawasaki Disease. If Kawasaki Disease is suspected, however, your doctor may order tests to monitor heart function (an echocardiogram) and might take blood and urine samples. In addition, your doctor may refer you to a pediatric specialist in infectious disease, rheumatology or cardiology for assistance in diagnosis and treatment. Complications if left untreated: If Kawasaki Disease is left untreated, it can lead to serious complications such as inflammation of the blood vessels. This can be particularly dangerous, because it can affect the coronary arteries—the blood vessels that supply blood to the heart. Aneurysms can also develop.An aneurysm is a ballooning out of a damaged and weakened blood vessel wall. Fortunately, treatment within the first 10 days of illness significantly decreases the risk for aneurysms to develop. Therefore, it is extremely important that a diagnosis is made by 10th day of the illness. Treatment should begin as soon as possible. Treatment for Kawasaki Disease:Children diagnosed with Kawasaki Disease are admitted to the hospital. The medication used to treat Kawasaki Disease in the hospital is called gamma globulin (IVIG). IVIG is given through an IV over 8 to 12 hours. Children may be given aspirin, as well, to lower the risk of heart problems. Children stay in the hospital for at least 24 hours after completing the IVIG dose to make sure the fever does not return and other symptoms are improving. Additional treatments may be necessary if a child does not respond well to the single dose of IVIG, the fever returns, or there are abnormal findings on the first echocardiogram. Another dose of IVIG or other medications that fight inflammation such as steroids, infliximab, or etanercept may be recommended. Pediatric specialists in rheumatology, infectious disease, or cardiology may be consulted in this situation.What to expect after hospital discharge: Children treated for Kawasaki Disease are sent home from the hospital on a low dose of aspirin to take by mouth every day for 6 to 8 weeks. As they recover, it is not uncommon for these children to be extra tired or seem ""off"" for several weeks. Rest is very important. Peeling of the hands and feet is expected and is not cause for alarm.Call your doctor right away if your child develops a fever or any of Kawasaki Disease's signs or symptoms return. Further evaluation is needed. Your child may need to be readmitted to the hospital. Follow-up Care: It is very important to closely monitor children who have had Kawasaki Disease for improvement and to check for the development of coronary aneurysms. Aneurysms most often form after the first couple of weeks of illness. Therefore, children should be scheduled for an echocardiogram and a check-up at 2 weeks and again at 6 to 8 weeks after their fever first started. More frequent follow up and echocardiograms will be necessary if there are abnormal findings on any of the echocardiograms.Note: Live viral vaccines should be postponed at least 11 months after IVIG, because IVIG may render the vaccines in-effective. This includes the MMR (measles, mumps, rubella) and the Varicella (chicken pox) vaccines. Children over 6 months of age should receive the inactivated influenza (flu) vaccine injection. Long-term follow-up:Children treated for Kawasaki Disease who do not develop aneurysms have an excellent long-term outcome. However, it is important for them to follow a heart healthy diet and lifestyle. Cholesterol levels should be checked every 5 years. Children who do have coronary aneurysms should be under the care of a pediatric cardiologist as they grow and will require special long-term care and follow-up. Additional Information & Resources:Fever and Your BabyHospital Care Coverage: Information for ParentsKawasaki Disease (CDC.gov)Kawasaki Disease Foundation Article Body Last Updated 1/20/2017 Source Section on Cardiology ＆ Cardiac Surgery (Copyright © 2017 American Academy of Pediatrics)"
396,19,"2018-04-19 02:48:19",Infections,381,"2018-04-19 03:40:41","Parenting with a Congenital Heart Defect: Why Prioritizing Your Own Health is Important","Parenting with a Congenital Heart Defect: Why Prioritizing Your Own Health is Important Page Content​​​If you are a parent who lives with a congenital heart defect (CHD), it can be challenging to balance the day-to-day demands of being a mom or dad while living with and caring for your own health.Who to Put First? It may be difficult some days to figure out who to put first – your children or yourself. When it is hard to find the energy to even get out of bed, it is important to take care of your own physical and emotional needs first. As a parent, this may not sound ""right,"" but the best gift you can give your child is to also care for yourself.A CHD can be unpredictable, as can your child's needs. Plan ahead. Ask for help. When a CHD overrules parenthood, call friends, family members or a sitter to help. Parenting changes with older children, but you still need to be okay with reaching out to others. Find time to relax. Whether visiting with friends, seeing a movie, meditating, or just reading, it is essential to make relaxation a priority. Lower your expectations. Your parenting style may be different from your sister's or your friend's, but that does not mean you are not a good parent. Lowering your expectations will help make meeting the challenges of parenting with a CHD seem easier. Planning for the FutureEvery person with a CHD should have a living will. It not only notifies your family members about your wishes, but it also guides them in decision making if you are unable to speak for yourself. Once you have a living will, be sure to: Store it in a safe place in your home and tell your family members where it is located. This is not a document to keep in the bank safety deposit box. It should be located in a secure but easily accessible spot in your home. Talk to your family about the instructions included in your living will. Family members are more accepting of a loved one's wishes if they are aware of what those are ahead of time.  Bring it to the hospital if you are admitted. Living wills are now required by hospitals so be sure to bring it with you if you are being admitted to the hospital. Additional Information from HealthyChildren.org:How Taking Care of Yourself Makes You a Better MomWhen Things Aren't Perfect: Caring for Yourself & Your ChildrenThe Greatest Gift You Can Give Your Child (Video)  ​ Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by ​a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers. Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
397,19,"2018-04-19 02:48:19",Infections,382,"2018-04-19 03:40:47","Pediatric Cardiomyopathy","Pediatric Cardiomyopathy Page Content​​​What is cardiomyopathy?Cardiomyopathy is a chronic heart condition that involves the deterioration of the heart muscle (myocardium). The heart muscle becomes abnormally enlarged, thickened and or stiffened. Eventually the heart is unable to pump effectively and cannot supply the body with enough blood to function. In severe cases, cardiomyopathy can lead to heart failure or sudden death. There are 5 forms of cardiomyopathy:Dilated cardiomyopathy (DCM)Hypertrophic cardiomyopathy (HCM)Restrictive cardiomyopathy (RCM)Arrhythmogenic right ventricular cardiomyopathy (ARCM)Left ventricular non-compaction cardiomyopathy (LVNC)Who gets cardiomyopathy?Cardiomyopathy predominantly affects adults, but in rare instances affects infants and children. According to the North American Pediatric Cardiomyopathy Registry, one out of 100,000 children in the U.S. is diagnosed with cardiomyopathy each year. However, this is a conservative number because it does not include all types of cardiomyopathies. Cardiomyopathy can occur in any child regardless of age, gender, race or economic background.Causes of cardiomyopathy in children: There are many causes of cardiomyopathy in children, including some that are not fully understood. Common causes include: Inheriting the condition from one or both parentsA viral infectionToxins affecting other organsUsing chemotherapy drugsMetabolic, mitochondrial or systemic diseases in parts of the body other than the heartDespite advances in genetic testing, the exact cause remains unknown in 2/3 diagnosed children.Symptoms of pediatric cardiomyopathy:Occasionally, symptoms of pediatric cardiomyopathy can be mistaken as a cold, flu, asthma, or stomachache. Some affected children have no symptoms while others may experience any of the following symptoms:Shortness of breath or rapid breathing Dizziness and faintingIrregular or rapid heartbeatAbdominal bloating or swellingChest painExtreme fatigueInfants may experience poor weight gain, extreme sleepiness, difficulty feeding or excessive sweating. How is pediatric cardiomyopathy diagnosed? A pediatric cardiologist confirms the diagnosis through an echocardiogram (echo) and electrocardiogram (EKG, or ECG). In some cases, other medical tests are necessary. Genetic testing may be recommended to verify the cause of the disease. Since pediatric cardiomyopathy is rare, it is recommended to locate a children's medical center with a wide range of experience in managing children with cardiomyopathy. Early diagnosis and treatment of the disease is essential to preventing complications and progression to heart failure. Treatment options for cardiomyopathy:There is no cure for cardiomyopathy, but the disease is treatable. Symptoms and complications can be well-controlled by medications, surgery, and implantable devices. The type of cardiomyopathy and its severity determines the treatment plan.  Medication is usually the first treatment option to improve the functioning of the heart. An implantable cardioverter defibrillator (ICD) may be needed to regulate heartbeat in children with irregular heart rhythms (arrhythmia).  A surgical procedure called a myectomy may relieve some symptoms in children with HCM. A heart transplant may be necessary if medical management is ineffective in controlling symptoms and preventing heart failure.Genetic considerations: Cardiomyopathy is often genetic, so it is important to assess a family's inheritance risk and discuss family screening. A pediatric cardiologist and a pediatric geneticist should work together to form a screening plan and discuss genetic testing options.How does the diagnosis impact a child's lifestyle? Although cardiomyopathy is a chronic condition, many children with cardiomyopathy lead a relatively normal life with few limitations. A diagnosis will likely involve more visits to the cardiologist and taking daily medications. Other adjustments may include restriction from competitive and contact sports, diet changes, and school accommodations.About sudden cardiac arrest:Often underdiagnosed, cardiomyopathy is the leading cause of sudden deaths in children under the age of 18. Because the disease can be present without symptoms, families should be aware of any family members who have heart disease or who died unexpectedly before age 50. Warning signs of sudden cardiac arrest: Recognizing the warning signs of sudden cardiac arrest is also important. If your child experiences any of the following, he or she should see a pediatric cardiologist for an extensive cardiac evaluation:Chest pain or discomfort when being physically activeUnexplained fainting or near faintingExcessive fatigue associated with exerciseUnusually fast heartbeatAdditional Information: Cardiac Conditions in Teens Your Family Health History & Genetics Pediatric Sudden Cardiac Arrest (AAP Policy Statement) Sudden Unexpected Death in Young Athletes: Reconsidering 'Hypertrophic Cardiomyopathy (Review article in Pediatrics) Children's Cardiomyopathy Foundation (CCF) - A non-for-profit organization that offers a variety of educational materials and suppo​rt services​​ Article Body Last Updated 9/26/2016 Source Copyright © 2016 American Academy of Pediatrics ＆ Children’s Cardiomyopathy Foundation"
398,19,"2018-04-19 02:48:19",Infections,383,"2018-04-19 03:40:51","Planning a Healthy Pregnancy with a Congenital Heart Defect","Planning a Healthy Pregnancy with a Congenital Heart Defect Page Content​​Women with a congenital heart defect (CHD) who, after preconception counseling, are able to have a safe or low-risk pregnancy, can take additional steps to plan for a healthy pregnancy.   Your Medical Care Team:Be sure your medical care team has knowledge and experience in treating pregnant women with a CHD. The specific members of this team may differ depending on where you live and what kind of heart condition you have. Congenital Cardiologist: In particular, one who specializes in adults with CHDs.Maternal-Fetal-Medicine Specialist: Also called a ""high-risk obstetrician"" and has experience caring for women with a CHD.  Genetic Counselor: Reviews your medical history and may perform testing to discuss the baby's risk for having a CHD. In general, a baby whose mother or father has a CHD has a small increased chance (about 5%) of being born with a CHD, too.Anesthesiologist: Can talk to you about anesthesia options for labor and delivery. Most women with a CHD can have an epidural during labor and delivery. Vaginal delivery is usually preferred over a caesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.Social Worker: Can help counsel you and your partner on how to handle the stress of managing both your cardiac and pregnancy health. During Your Pregnancy: It is very important to maintain regular care with your obstetrician and congenital cardiologist throughout your pregnancy. Although most women will do well and have healthy pregnancies, women with a CHD do have a higher risk for pregnancy complications, including arrhythmias or irregular heartbeats and premature birth. Your congenital cardiologist ​will determine how often you will require cardiac care during pregnancy. Most women with a CHD see their congenital cardiologist once each trimester, but sometimes more frequent appointments are needed. Your doctor will also determine whether you need cardiac testing during your pregnancy. Most women with a CHD receive an echocardiogram (ultrasound of the heart) early in pregnancy and in the last trimester.As with any pregnant woman, there are ways you can help reduce health risks to your baby before and during pregnancy: Take a daily prenatal vitamin that includes folate.Avoid smoking, alcohol and other drugs (other than medications prescribed by your doctor).Eat a healthy diet.  Exercise.Get enough rest.Labor & Delivery:At some point, you will discuss the type of delivery—vaginal or cesarean section—with your obstetrician. Typically, a vaginal delivery is preferred over a cesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.Regardless of the type of delivery, an anesthesiologist is usually involved to assist with pain control. Most women with a CHD can have an epidural during labor and delivery, but some types of medicine for pain control can affect the heart rate and blood pressure—why meeting with an anesthesiologist before delivery is important!Your Baby's Health:Your baby is at increased risk of being born with a CHD if you or your baby's father have a CHD. Preconception counseling can also assess your baby's CHD risk. Once you're expecting, your doctor will do a special ultrasound of your baby's heart, called a fetal echocardiogram, to see if your baby has any major structural issues to the heart.  Additional Information from HealthyChildren.org:Tests & Screenings During PregnancyLet Baby Set the Delivery Date: Wait until 39 Weeks if You CanParenting with CHD: Why Prioritizing Your Own Health is Important​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​​ Article Body​​ Last Updated 10/28/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
399,19,"2018-04-19 02:48:19",Infections,384,"2018-04-19 03:40:57","Preconception Counseling for Women with a Congenital Heart Defect","Preconception Counseling for Women with a Congenital Heart Defect Page Content​​Even though pregnancy and childbirth stress the heart, most women with a congenital heart defect (CHD) are able to have healthy pregnancies if they choose to do so.Women with a CHD interested in getting pregnant should see a health care professional who specializes in CHDs before becoming pregnant to determine any risks for complications during pregnancy. Preconception counseling—as it is called—can identify any heart problems that may need treatment before conception to assess a baby's risk of being born with a CHD.  Consult with a Specialist: If you have a CHD and are considering becoming pregnant, you should schedule an appointment with a congenital cardiologist. You will need to tell the congenital cardiologist if you have any cardiac symptoms, such as:Shortness of breathFatigue Chest pain Dizziness Heart palpitations (i.e. a feeling like your heart is fluttering or beating too fast or too hard)  Bring a list of all of your medications to a preconception counseling appointment for review. Some medications should not be taken during pregnancy.  Cardiac Testing Prior to Conception: Your doctor will perform special medical tests​​ to see if your heart can handle the increased demands of pregnancy. At a minimum, you will receive an echocardiogram—a type of ultrasound that allows doctors to see a video of the heart.Depending on your symptoms and echocardiogram results, your doctor may perform other tests such as:Holter monitoring: Provides a constant reading of your heartbeat so your doctor can see if you have an unusual heart rhythm.Exercise test: Shows your doctor how your heart handles stress when it needs to work harder.Cardiac MRI: Another type of imaging test that can very accurately show heart size and how well the heart is working. About catheterization: Occasionally, pre-conception ​​test results show that a woman needs a surgery or a catheterization—a nonsurgical way to treat the heart. Catheterization is done by inserting a thin tube into a blood vessel in the neck, arm or leg and threading it to the heart. Your doctor may recommend performing surgery or catheterization before pregnancy to treat damage to a heart valve, narrowing of a vessel, or an aneurysm.Determining Risks for Pregnancy Complications:Your congenital cardiologist will give you a ""risk assessment"" on your likelihood to have cardiac complications during pregnancy. In some cases, your doctor may say your risk of having a dangerous pregnancy is very high. In this situation, discussions with your doctors can help you and your partner better understand these risks as well as consider other options.  Preconception Counseling with Other Specialists:Ask your congenital cardiologist for help finding other medical specialists who can help you make decisions about pregnancy and delivery. Maternal-Fetal-Medicine Specialist: Also called a ""high-risk obstetrician"" and has experience caring for women with a CHD.  Genetic Counselor: Reviews your medical history and may perform testing to determine the baby's risk for having a CHD. In general, a baby whose mother or father has a CHD has a small increased chance (about 5% on average) of being born with a CHD, too.Anesthesiologist: Can talk to you about anesthesia options for labor and delivery. Most women with a CHD can have an epidural during labor and delivery. Vaginal delivery is usually preferred over a cesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.Social Worker: Can help counsel you and your partner on how to handle the stress of managing both your cardiac and pregnancy health. Remember…Parenting can be hard. It is important to talk to your congenital cardiologist about how a CHD will affect your health after delivery, too. See Parenting with CHD: Why Prioritizing Your Own Health is Important. Additional Information from HealthyChildren.org: Your Family Health History & GeneticsPrenatal Genetic CounselingTests & Screenings During Pregnancy​Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.​ Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"
400,19,"2018-04-19 02:48:19",Infections,385,"2018-04-19 03:41:02","Reproductive Health in Young Women with Congenital Heart Defects","Reproductive Health in Young Women with Congenital Heart Defects Page Content​​​A congenital heart defect (CHD) is the most common type of birth defect. Due to advances in medical and surgical therapies, more than 90% of infants born with a CHD will live to see their 18th birthday. As dreams of a full and rich adult life—including a career and family—frequently become reality, adolescents and adults should receive specialized cardiology care throughout their lifetime. The impact of a CHD and its interaction with typical conditions of adulthood such as pregnancy, diabetes, and hypertension must be considered as women living with CHD age. ​​​""Young women living with a CHD can expect better outcomes if they partner with their health care team when making health decisions, especially when it comes to reproductive health,"" said Elyse Foster, M.D., a cardiologist at the University of California, San Francisco, and a member of the Congenital Heart Public Health Consortium (CHP​HC). Anyone who has a heart murmur or had heart surgery as a child should be evaluated by a congenital cardiologist as an adult. Women living with a CHD, specifically, can make informed choices and decrease their chances of a high-risk birth when they work with their health care team. While the overall risk of complications during pregnancy is relatively low, women with a CHD are still eight times as likely to experience cardiovascular complications during pregnancy. Reproductive health considerations should start even before a young woman is ready to start a family. These topics should include contraception, the decision to carry a pregnancy, and the challenges of parenting with a CHD. See the articles below for more information on each subject. Birth Control for Young Women with a CHD Preconception Counseling for Women with a CHDPlanning a Healthy Pregnancy with a CHDGenetics and CHDsParenting with a CHD: Why Prioritizing Your Own Health Is Important​""Guidelines and recommendations for care are available for the management of adult patients with congenital heart defects,"" said Michelle Gurvitz, M.D., a cardiologist at Boston Children's Hospital and a member of the CHPHC. ""However, even with the availability of this information, too great a number of patients fall through the cracks in the system."" Dr. Gurvitz advocates for a team-based approach to care for her adult patients, including congenital cardiology, primary care and other specialties as needed—including obstetrics, gynecology and psychology. Additional information regarding congenital heart defects and lifelong cardiac care is available at the CHPHC website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers. Article Body Last Updated 11/7/2016 Source Congenital Heart Public Health Consortium (CHPHC)"