abstract：:Although vaccine acceptance and uptake are overall high among children in the United States, vaccine delays or refusals are a growing concern. Vaccine hesitancy is a challenge for the pediatric provider, given the diverse factors associated with hesitancy and the limited evidence on effective strategies for addressing...
abstract：:The Safe to Sleep campaign started in 1994, reducing the risk of sudden infant death syndrome (SIDS) by 40% to 60%. However, an undesirable consequence has been a 400% to 600% increase in positional head deformities. We review the risks for positional plagiocephaly or brachycephaly, treatment modalities, and when to r...
abstract：:Medical child abuse (MCA) continues to remain a challenging form of abuse to recognize, diagnose, and manage. The perpetrators of MCA have some common features that may heighten the suspicion that a child is the victim of MCA. Once suspected, the development of a multidisciplinary care plan that incorporates all subsp...
abstract：:The first pediatric coronavirus disease 2019 (COVID-19) case was confirmed in Shenzhen, China on January 20, 2020. At the beginning of the outbreak, COVID-19 pneumonia was more common in adults than in children and adolescents, and the rate of confirmed pediatric cases was relatively lower. However, as screening tests...
abstract：:Sleep disorders are one of the most frequent comorbidities in children with autism spectrum disorder (ASD). Heterogeneous sleep problems in children with ASD have been reported, and insomnia has a prevalence in children with ASD ranging from 60% to 86%. Poor sleep can cause harmful effects on cognitive functions, fost...
abstract：:Cultural health beliefs and practices often affect accuracy of diagnoses, health care delivery, and treatment plan adherence, which can lead to health disparity. However, the effect of these belief systems, and acceptance of health care provider recommendations is not commonly discussed. As the proportion of patients ...
abstract：:Heavy menstrual bleeding (HMB) is a common complaint among adolescent girls. It reflects an abnormal volume of blood loss during the menstrual cycle. Abnormal uterine bleeding can manifest as HMB but includes menstrual irregularity. In many cases, immaturity of the hypothalamic-pituitary-ovarian axis or hormonal condi...
abstract：:Atopic dermatitis (AD) is the most common inflammatory skin condition in pediatric patients. AD has long been associated with comorbidities including food allergies, asthma, and allergic rhinitis, but recent literature has expanded this list to include attention-deficit/hyperactivity disorder and depression. AD has tr...
abstract：:Platelets are an essential component of the hemostatic pathway; therefore, it is important to identify and diagnose patients with low platelet counts. This can be challenging, however, because thrombocytopenia can be relatively common and the differential diagnosis can be broad. Furthermore, because platelets can be a...
abstract：:We report on a case of a 14-year-old phenotypic female with a microdeletion at 13q31.1-q31.3, dysmorphic facial and limb features, and neurologic symptoms. She presented to her pediatrician with concerns for delayed puberty, and laboratory analysis revealed hypergonadotropic hypogonadism. She was found to have an XY k...
abstract：:Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a rare, benign, and self-limited disease that causes lymphadenopathy and has a characteristic histological appearance. The etiology of this disease is unknown, but a possible infectious trigger has been hypothesized. In the adult population t...
abstract：:Children comprise a special group of international travelers. Immigrant and refugee children, along with children traveling to visit friends and relatives abroad or on leisure trips, require special attention by clinicians to prevent and treat travel-related conditions. [Pediatr Ann. 2019;48(9):e360-e369.]. ...
abstract：:Monogenic diabetes affects approximately 120,000 people in the United States but continues to be misdiagnosed. Within the pediatric population, 1% to 3% of diabetes is monogenic, and early diagnosis and genetically targeted management of congenital diabetes and maturity onset diabetes of the young (MODY) can have a tr...
abstract：:Immune status during pregnancy is an important consideration, and all women who are pregnant should be screened for immunity to certain diseases. Women who are pregnant are at higher risk of contracting infections, and many infections can cause serious problems for a growing fetus. For this reason, remaining up-to-dat...
abstract：:Concussions are common in pediatric athletes, but they often go underreported. The topic of concussions has garnered much attention from the media recently, and this attention has resulted in the development of stricter guidelines for management of concussion by professional sporting leagues such as the National Footb...
abstract：:Exercise-induced dyspnea in children and adolescents can occur for many reasons. Although asthma is the common cause, failure to prevent exercise-induced asthma by pretreatment with a bronchodilator, such as albuterol, indicates that other etiologies should be considered. Other causes of exercise-induced dyspnea inclu...
abstract：:Certain rashes and cutaneous lesions in a newborn can be clues to more concerning diseases and conditions if recognized and evaluated promptly. Langerhans cell histiocytosis, cutaneous forms of cancer (such as leukemia cutis, neuroblastoma, and rhabdomyosarcoma), developmental abnormalities such as neural tube or spin...
abstract：:Restless legs syndrome (RLS) is a common pediatric condition that often goes undiagnosed. The genetics and pathophysiology of this sensorimotor condition are still not well understood. RLS can affect any part of the body, but the thighs and calves are the most commonly affected. Because of unpleasant sensations caused...
abstract：:Traditionally, nutritional risk has been defined by growth failure, with clinical intervention indicated when a child falls below the third to fifth percentile on growth charts. Although the velocity of linear growth and weight gain during the first years are unparalleled at any other time of life, this period is also...
abstract：:This article reviews the definition, pathophysiology, etiology, assessment, and management of acute respiratory failure in children. Acute respiratory failure is the inability of the respiratory system to maintain oxygenation or eliminate carbon dioxide. Acute respiratory failure is a common cause for admission to a p...
abstract：:Neonatal intestinal obstruction is caused by an anatomical abnormality that produces bowel movement failure. Intestinal obstruction presents with three classic clinical signs: vomiting, abdominal distention, and failure to pass meconium. Intestinal obstruction is one of the most common causes for admitting a pediatric...
abstract：:Adolescence is a stressful time with a considerable amount of change, not only physically, with all the changes expected throughout puberty, but also emotionally, spiritually, and psychosocially. Teens are learning how to build and sustain relationships, learning boundaries in all areas of their lives, experimenting, ...
abstract：:Emergencies do occur in pediatric primary care offices. The American Academy of Pediatrics Committee on Pediatric Emergency Medicine recommends that primary care offices perform a self-assessment of office readiness for emergencies. Primary care offices should develop an emergency response plan to recognize, stabilize...
abstract：:Adrenarche is when a child's adrenal cortex starts to secrete adrenal androgen precursors. Dehydroepiandrosterone (DHEA) is the most abundant product of the adrenal cortex, and is a weak androgen agonist thought to be responsible for the clinical signs of pubarche by conversion to more potent androgens, testosterone, ...
abstract：:Nonpharmaceutical household products are the most common substances involved in exploratory ingestions in young children. Fortunately, most of these products are not toxic if ingested in small volumes. However, there are several household products that have the potential to cause significant toxicity and, rarely, fata...
abstract：:Congenital hyperinsulinism is a rare disorder that commonly presents in the immediate postnatal period as persistent hypoglycemia. The condition is frequently resistant to medical therapies, and the genetic mutations implicated in the disorder can be predictive of response to therapy. Evaluation of hypoglycemia in the...
abstract：:Children with ventilator assistance have been supported in living at home since 1981 when parental advocacy ushered in a change to Medicaid policy. As the population of children who use medical technology such as long-term ventilation increases, we must critically evaluate our systems for preparing families for home l...
abstract：:Insufficient sleep duration and poor sleep quality are common among adolescents. The multidimensional causes of insufficient sleep duration and poor sleep quality include biological, health-related, environmental, and lifestyle factors. The most common direct consequence of insufficient and/or poor sleep quality is ex...
abstract：:Attention-deficit/hyperactivity disorder (ADHD) was added to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised in 1987. Similar disorders had appeared earlier, and many consider the first description of ADHD to be a lecture in 1902 about children with an "abnormal defect in moral contro...
abstract：:The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. ...
abstract：:Brief resolved unexplained event (BRUE) is a common pediatric problem that presents to ambulatory and emergency settings. Infants presenting with a BRUE can be separated into low- and high-risk groups per recent guidelines. Most low-risk infants who present with a BRUE can be discharged home with anticipatory guidance...
abstract：:Vaccine discussions are an important part of the general pediatrician's day. The human papillomavirus (HPV) vaccine, in particular, has been slow to gain acceptance by the general public. It has recently gained momentum (both positive and negative) on social media, which has led to an increase in questions and concern...
abstract：:Hepatitis is defined as inflammation of the liver. This inflammation can be acute and self-limited, chronic (leading to cirrhosis and an increased risk for hepatocellular carcinoma), or fulminant (requiring lifesaving liver transplantation). Although there are many causes of hepatitis, this article focuses on the main...
abstract：:Every pediatrician has likely experienced frustration with cases of chronic nasal symptoms that either do not seem to get better or do show improvement but then worsen again. Often, this leads to the diagnosis of allergic rhinitis or sinusitis and subsequent prescription of medication(s) that may or may not be warrant...
abstract：:Youth with anxiety often present to their pediatricians with a chief complaint of physical symptoms without any mention of anxiety or worry. Even in the absence of reported symptoms of anxiety in such presentations, screening for an anxiety disorder as the potential source of the somatic complaints should be pursued. ...
abstract：:Acute appendicitis is the most common cause of emergent surgery in children. Historically, surgical dogma dictated emergent appendectomy due to concern for impending perforation. Recently, however, there has been a paradigm shift in both the understanding of its pathophysiology as well as its treatment to more nonoper...
abstract：:Developmental trigger thumb, although uncommon, can be easily identifiable in the pediatric outpatient visit. Patients often present with their thumb locked in flexion and a firm nodule at the base of the thumb. The thumb is usually passively correctable and nonpainful. It is important to examine the opposite thumb as...
abstract：:Children begin ballet lessons as young as age 2 years. The graceful movements of classical ballet require a combination of artistry, flexibility, and strength to perform. During the training and development of a young ballerina, the transition to dancing en pointe ("on the toes") represents a significant milestone and...
abstract：:About 18% of all children in the United States have complex medical diseases, require technologic support, and/or have developmental or intellectual disability. These children require routine or maintenance care through the medical-home model. However, due to a lack of physicians, time, and financial constraints it is...
abstract：:Pediatricians have significant roles in preventive health care, and understanding how various exposures during childhood can have long-lasting effects on cancer risk is critical in promoting future health. With the exception of rare genetic syndromes conferring increased cancer susceptibility, most cancers are conside...