A detailed advanced literature search using PubMed, Goggle Scholar and Medline was done, aimed at accessing peer reviewed full journal articles, abstracts, reviews, comments, letters to editors, project reports, dissertations, theses and books relevant to the subject area. The keywords employed include the following: clinical pharmacokinetics, developmental changes, drug absorption, drug distribution, drug elimination, drug interaction, drug metabolism, pediatrics and physiologically based pharmacokinetic (PBPK) model.
Management of hypertension (HTN) largely relies on proper and accurate measurement of blood pressure (BP). Even following the criteria for HTN diagnosis defined in the Fourth report on high BP in children and adolescents, inaccu- rate diagnosis and misdiagnosis can occur with white coat effect and masked HTN. The use of Ambulatory Blood Pres- sure Monitoring (ABPM) has been increasing in pediatrics in the last 20 years. The main use of ABPM is to differenti- ate between sustained HTN and white coat HTN in patients who have elevated casual BP measurements and to detect masked HTN in high risk patients. ABPM is most useful in patients with casual BP within 20% of the 95th percentile for age, gender, and height. This report will highlight the use of ABPM in the evaluation of elevated BP and management of HTN in pediatrics. The discussion includes a review of various non-invasive BP measuring techniques, a description of ABPM and ABPM-unique data and diagnoses, updated ABPM clinical data more specific to pediatrics, its use in HTN clinical trials, and future outlook and direction of ABPM in pediatrics.
able to demonstrate that “a diffusely red, nonbulging, dull tym- panic membrane, mobile to negative and positive pressure, must be considered nonpathologic. A completely bulging yellow, opac- ified tympanic membrane…was the most frequently observed sign of acute otitis media.” In addition, Schwartz found that fever was only present in 61% of patients with confirmed AOM. Symp- toms of pain, including tugging of the ear, were absent in 20% of young patients. Finally, “segmental AOM should be considered as representing AOM with effusion” and “all three major effusion types, namely purulent, serous, and mucoid, can occur acutely.” The above-mentioned findings are all in conflict with the complex criteria listed in the American Academy of Pediatrics/American Academy of Family Physicians diagnostic table. Continuing to promote a red TM as one of the important findings of AOM is incorrect and misleading.
Methods: It was a prospective study was conducted in the Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India over a period of one year from August 2017 to August 2018. A total of 250 children aged 1-36 months were included in the study. A proper history and examination were done in each case. A clean catch mid-stream urine sample was obtained from each child. Quantitative microscopy and urine culture were performed. Standard biochemical tests were done to identify the isolates and for determination of antibiotic sensitivity.
It indicates an analysis of the strengths and weaknesses of the implementation of standards and the factors influencing the preparation of residents for clinical practice, focusing on the assessment of the educational programs quality of the pediatrics department in Shiraz Medical School, Iran. There is an attempt to identify departmental performance regarding input, process and output standards areas. As such, it reviews the eligibility requirements, mission, and extent of mission fulfillment, and core themes with objectives and indicators of achievement. This paper is intended to clarify the need for fresh approaches to the residency educational programs for further development of contemporary and future medical practice. It also describes responsibilities of EDC regarding the quality of medical education.
While hospitalist systems have also been able to dem- onstrate effective teaching, our system is a different clin- ical care model. Our faculty group represents both generalist and subspecialty faculty attendings, all of whom have other aspects to their career, such as ambu- latory care and subspecialty clinical care, research, edu- cational administration, clinical program building, and teaching [14-17]. Our institution currently does not have an academic division of hospital medicine. Our current model hybridizes the benefits of a traditional ward attending service, which includes enhancing resident au- tonomy and ownership in decision making, along with participation of faculty from subspecialty and general pediatrics, while including additional hours of dedicated attending time for teaching and clinical care. Our hybrid model allows individual faculty to contribute part of their overall effort to the general service yet maintain their home in their academic division. We facilitate this community of ward and teaching attending faculty through faculty development sessions throughout the year on such topics as giving and receiving feedback, small group teaching and improving bedside teaching.
In the years since its inception, Pediatrics has served a number of functions for the AAP and its membership. In addition to providing an excellent and respected forum for the publication and discus- sion of pediatric research and clinical experience, Pediatrics has been, aside from membership dues themselves, the most consistent and significant source of income for the AAP over the past 50 years. This income, of which advertising revenues remain a primary portion, helps to defray many member ex- penses and, perhaps most importantly, fund many important AAP initiatives, including research projects, advocacy programs, educational activities, community outreach efforts, and other activities pre- scribed by the AAP’s mission. In short, the growth of the Journal and the growth of the AAP are, in many ways, directly linked.
Although body modifications have become a mainstream trend, they still may be associated with medical complications and, among adolescents, may also co-occur with high-risk behaviors. This first clinical report from the American Academy of Pediatrics on tattooing, piercing, and scarification discusses the history of these methods of body modification, educates the reader on methods used, reports on trends in associated adolescent and young adult risk behaviors, differentiates between nonsuicidal self-injury (NSSI) and body modifications, and educates the reader about how to anticipate and prevent potential medical complications. The report analyzes the literature about societal acceptance of people with body modifications and perceptions that
Intraoperative neurophysiologic monitoring has shown a steady increase in use for surgeries in which neural structures may be at risk of injury. Some of the surgical techniques used carry inherent risks, and these risks have changed the way in which neurophysiologic monitoring has impacted patient safety and quality of care during surgical procedures. It is therefore crucial that those performing and interpreting intraoperative neurophysiologic monitoring are adequately trained. This book is a comprehensive guide to the current practice of intraoperative neurophysiology with chapters on various modalities and clinical uses. Separate chapters devoted to anesthesia, operating room environment, special considerations in pediatrics and the interpretation and reporting of neurophysiologic data are useful and complementary. Questions and detailed answers on the topics covered can be found on the accompanying website for study review. This book will be useful to the trainee as well as the neurophysiologist already in practice.
Of greater clinical interest is the predictive accu- racy of the Nasal Obstruction Index, particularly at its upper and lower extremes, where uncertainty must be at a minimum if the Index is to be useful diagnostically. Table 9 shows, on the left, calculated positive and negative predictive values in the study population, in which the prevalence of roentgeno- grams showing either obstruction or borderline ob- struction was 33.1% (342/1033). Because predictive accuracy varies with prevalence, and because the prevalence of nasal obstruction in the study popula- tion was probably higher than in the general popu- lation of children, we used Bayes’ theorem 26 and our