Puericultura

Flatfoot (pes planus) is common in infants and children and often resolves by adolescence. Thus, flatfoot is described as physiologic because it is usually flexible, painless, and of no functional consequence. In rare instances, flatfoot can become painful or rigid, which may be a sign of underlying foot pathology, including arthritis or tarsal coalition. Despite its prevalence, there is no standard definition for pediatric flatfoot. Furthermore, there are no large, prospective studies that compare the natural history of idiopathic, flexible flat feet throughout development in response to various treatments...

Presentation of Case. Dr. Patricia M. Guglietta: A 9.5-year-old girl with chronic constipation was seen in the gastroenterology clinic of this hospital because of recurrent episodes of abdominal pain with associated nonbilious vomiting. The patient had been generally well until she was 4 years of..

• On the basis of observational studies (level C), preterm birth is a leading cause of neurodevelopmental disabilities in children, and the degree of neurodevelopmental disability is inversely correlated with gestational age at birth. When comparing performance of preterm children to developmental norms, “corrected age” or age from due date rather than birth date should be used for the first 24 to 36 months. • On the basis of observational studies (level C), clinicians should pay specific attention to sensory function in children born preterm because the incidence of visual and hearing impairments is higher in preterm than term children...

Insomnia in children is complex and frequently multifactorial. This review discusses the major categories of insomnia as well as common causes. The consequences of insomnia, including issues with mood, behavior, and cognition, are discussed. Sleep disorders are much more prevalent in certain pediatric populations, such as children with autism spectrum disorders. The evaluation of insomnia in children includes a focused history and examination and occasionally actigraphy or polysomnography. Behavioral and pharmacological therapies are discussed, as are future directions for research and clinical practice...

Functional abdominal pain (FAP) is common in childhood, but is not often caused by disease. It is often the impact of the pain rather than the pain itself that results in referral to the clinician. In this review, we will summarise the currently available evidence and discuss the functional dimensions of the presentation, within the framework of commonly expressed parental questions. Using the Rome III criteria, we discuss how to classify the functional symptoms, investigate appropriately, provide reassurance regarding parental worries of chronic disease...

No abstract text is available yet for this article.

Pityriasis alba (PA) is a skin disorder that affects children and adolescents. Although it is common worldwide, its incidence is markedly higher in darker skin phototypes. Its characteristic features include an extended, multistage course and spontaneous remissions and recurrences. Preceded by erythematous changes, patches of hypopigmented skin of up to a few centimeters in diameter appear on the upper body. Pruritus may accompany it. Even though its etiology is unknown, possible reported triggering factors include sunlight, beauty treatments, and microorganisms, among others...

Sudden cardiac death (SCD) affects 2/100,000 young, active athletes per year of which 40% are less than 18 years old. In 2004, the International Olympic Committee accepted the Lausanne Recommendations, including a 12-lead electrocardiogram (ECG), as a pre-participation screening tool for adult Olympic athletes. The debate on extending those recommendations to the pediatric population has recently begun. The aims of our study were to highlight the characteristics of the young athlete ECG, phenotypical manifestations of SCD-related disease in children, and challenges of implanting ECG screening in athletic children...

A 10-month-old male infant weighing 7.34 kg (2nd percentile for age and sex) presented with a 4-day history of nonbilious, nonbloody emesis. He had a history of frequent nonbilious emesis and poor weight gain since birth. He had difficulty consuming solid foods and was given a diagnosis of reflux...

This paper explores two areas in which the translation of research into practice may be improved in the management of cry-fuss behaviours in the first few months of life. Firstly, babies who cry excessively are often prescribed proton pump inhibitors, despite evidence that gastro-oesophageal reflux disease is very rarely a cause. The inaccuracy of commonly used explanatory mechanisms, the side-effects of acid-suppressive medications, and the failure to identify treatable problems, including feeding difficulty when the diagnosis of 'reflux' is applied, are discussed...

BACKGROUND: Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance. AIMS: To review current clinical practice and identify published literature on the management of lactose intolerance. METHODS: PubMed was searched using the terms lactose, lactase and diet to find original research and reviews...

The American Academy of Pediatrics Committee on Nutrition presents an updated review of lactose intolerance in infants, children, and adolescents. Differences between primary, secondary, congenital, and developmental lactase deficiency that may result in lactose intolerance are discussed. Children with suspected lactose intolerance can be assessed clinically by dietary lactose elimination or by tests including noninvasive hydrogen breath testing or invasive intestinal biopsy determination of lactase (and other disaccharidase) concentrations...

No abstract text is available yet for this article.

On the basis of strong clinical evidence, congenital hypothyroidism should be identified and treated early to avoid potentially profound cognitive deficits. On the basis of strong clinical evidence, the dose of levothyroxine is higher at early ages and progressively decreases into adulthood. On the basis of observational studies and consensus, children with congenital hypothyroidism and a eutopic thyroid gland should discontinue levothyroxine treatment at age 3 years to determine whether their hypothyroidism was transient...

BACKGROUND: Little is known about the impact of interventions to support shared decision making (SDM) with pediatric patients. OBJECTIVES: To summarize the efficacy of SDM interventions in pediatrics on patient-centered outcomes. DATA SOURCES: We searched Ovid Medline, Ovid Embase, Ovid Cochrane Library, Web of Science, Scopus, and Ovid PsycInfo from database inception to December 30, 2013, and performed an environmental scan. STUDY ELIGIBILITY CRITERIA: We included interventions designed to engage pediatric patients, parents, or both in a medical decision, regardless of study design or reported outcomes...

Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2010 clinical report on head lice was published by the American Academy of Pediatrics, newer medications have been approved for the treatment of head lice. This revised clinical report clarifies current diagnosis and treatment protocols and provides guidance for the management of children with head lice in the school setting.

BACKGROUND AND OBJECTIVE: Children with ankyloglossia, an abnormally short, thickened, or tight lingual frenulum, may have restricted tongue mobility and sequelae, such as speech and feeding difficulties and social concerns. We systematically reviewed literature on feeding, speech, and social outcomes of treatments for infants and children with ankyloglossia. METHODS: Medline, PsycINFO, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVES: To examine the relationship between mandatory naptimes in child care and children's nighttime sleep duration, both concurrently and 12 months later once in school. METHODS: A sample of 168 children (50-72 months; 55% males) attending licensed child care centers were observed across their morning and throughout their scheduled naptime. Mandatory naptime was determined as the period in which children were not permitted any alternative activity except lying on their bed...