scholarly journals Approach to pediatric rotational limb deformities

2019 ◽  
Author(s):  
Huthayfa Kahf ◽  
Yazeed Kesbeh ◽  
Eric Van Baarsel ◽  
Vandan Patel ◽  
Nicholas Alonzo
Keyword(s):  
Pediatric Population ◽  
Primary Care Providers ◽  
Femoral Anteversion ◽  
Common Source ◽  
Care Providers ◽  
Developmental Abnormalities ◽  
Childhood Growth ◽  
Common Causes ◽  
Limb Deformities ◽  
Pediatric Orthopedic

Pediatric lower extremity complaints are a common source of concern for parents. Gait concerns such as in-toeing are considered a developmental variant of childhood growth and are a common reason for visits to a pediatrician. In-toeing specifically is a common anatomic structural variation encountered by pediatric primary care providers and pediatric orthopedic specialists and may be accentuated between six months and five years during which children are developing their coordination skills. This study focuses on the three most common causes of in-toeing in the pediatric population; femoral anteversion (FA), tibial torsion (TT), and metatarsus adductus (MA) with the purpose of providing a brief review to give providers confidence in addressing these common developmental abnormalities.

Analysis of Body Mass Index (BMI) Trends Among a Pediatric Dental Patient Population: A Pilot Study. (Preprint)

2021 ◽  
Author(s):  
Tengfei Su ◽  
Mac Jackson ◽  
Keaton Sacry ◽  
Karl Kingsley MPH
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Low Income ◽  
Patient Population ◽  
Pediatric Population ◽  
Primary Care Providers ◽  
Overweight And Obesity ◽  
Dental School ◽  
Care Providers ◽  
Over Time

BACKGROUND Over the past few decades, a growing trend of overweight and obesity has emerged among the pediatric population. This is a cause of significant concern as these are significantly correlated to other negative oral and systemic health outcomes over time. Although measurement of body mass index (BMI) is common among pediatric physicians and primary care providers, few studies have explored the feasibility of BMI measurement and analysis from pediatric dental providers. OBJECTIVE The primary objective of this study was to compile and analyze pediatric BMI measurements taken from a pediatric dental school patient population. METHODS This study was a retrospective analysis of previously collected data of pediatric patients between 2012 and 2019 (N=451), which was reviewed and approved by the Institutional Review Board (IRB). Descriptive statistics and trend analysis were compiled to determine the trends in pediatric BMI over time. RESULTS Nearly equal percentages of females and males were represented in the study (P=0.432), with the overwhelming majority identified as racial/ethnic minorities (84.5%), P=0.0075. These data revealed that pediatric BMI increased significantly from 25.6 in 2012 to 31.3 in 2018 (22.1%), P=0.031. No significant differences between males and females were observed (P=0.4824) or between minority and non-minority patients (P=0.8288). CONCLUSIONS This study provides significant novel temporal information regarding pediatric BMI among this low-income, minority patient population and highlights the need for expanding the dental school (and pediatric dental residency) curriculum to include more topics related to measuring and tracking overweight and obese children and the most appropriate methods for use in the pediatric dental office.

Pediatric Orthopedic Emergencies

2018 ◽  
Author(s):  
Priya Gopwani ◽  
Joy Koopmans
Keyword(s):  
Pediatric Population ◽  
Skeletal Development ◽  
Adult Population ◽  
Slipped Capital Femoral Epiphysis ◽  
Optimal Growth ◽  
Developmental Abnormalities ◽  
Osteoarticular Infections ◽  
Key Words Bone ◽  
Orthopedic Injuries ◽  
Pediatric Orthopedic

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. This review contains 9 figures, 13 tables and 45 references Key words: bone, musculoskeletal, orthopedic, skeletal

Pediatric Orthopedic Emergencies

2016 ◽  
Author(s):  
Priya Gopwani ◽  
Joy Koopmans
Keyword(s):  
Pediatric Population ◽  
Skeletal Development ◽  
Adult Population ◽  
Slipped Capital Femoral Epiphysis ◽  
Optimal Growth ◽  
Developmental Abnormalities ◽  
Osteoarticular Infections ◽  
Key Words Bone ◽  
Orthopedic Injuries ◽  
Pediatric Orthopedic

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. Key words: bone, musculoskeletal, orthopedic, skeletal

What is dementia?

2021 ◽  
pp. 3-10
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Primary Care ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Primary Progressive Aphasia ◽  
Normal Pressure ◽  
Primary Care Providers ◽  
Care Providers ◽  
Common Cause ◽  
Common Causes ◽  
Daily Function

Dementia is the term used to describe progressive impairment of thinking and memory that interferes with daily function. Dementia is not a specific disorder; rather, it is a condition with many causes. Alzheimer’s disease is the most common cause of dementia. Other common causes of dementia include vascular dementia, dementia with Lewy bodies, primary progressive aphasia which comes in the logopenic, semantic, and nonfluent/agrammatic variants, behavioral variant frontotemporal dementia, and normal pressure hydrocephalus. Primary care providers are able to diagnose most straightforward cases of dementia, whereas specialists such as neuropsychologists, neurologists, psychiatrists, and geriatricians may be needed when the diagnosis is not straightforward.

Pediatric Orthopedic Emergencies

2018 ◽  
Author(s):  
Priya Gopwani ◽  
Joy Koopmans
Keyword(s):  
Pediatric Population ◽  
Skeletal Development ◽  
Adult Population ◽  
Slipped Capital Femoral Epiphysis ◽  
Optimal Growth ◽  
Developmental Abnormalities ◽  
Osteoarticular Infections ◽  
Key Words Bone ◽  
Orthopedic Injuries ◽  
Pediatric Orthopedic

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. This review contains 9 figures, 13 tables and 45 references Key words: bone, musculoskeletal, orthopedic, skeletal

What is dementia?

2021 ◽  
pp. 3-10
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Primary Care ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Primary Progressive Aphasia ◽  
Normal Pressure ◽  
Primary Care Providers ◽  
Care Providers ◽  
Common Cause ◽  
Common Causes ◽  
Daily Function

Dementia is the term used to describe progressive impairment of thinking and memory that interferes with daily function. Dementia is not a specific disorder; rather, it is a condition with many causes. Alzheimer’s disease is the most common cause of dementia. Other common causes of dementia include vascular dementia, dementia with Lewy bodies, primary progressive aphasia which comes in the logopenic, semantic, and nonfluent/agrammatic variants, behavioral variant frontotemporal dementia, and normal pressure hydrocephalus. Primary care providers are able to diagnose most straightforward cases of dementia, whereas specialists such as neuropsychologists, neurologists, psychiatrists, and geriatricians may be needed when the diagnosis is not straightforward.

Pediatric Aural Foreign Body Extraction: Comparison of Efficacies Among Clinical Settings and Retrieval Methods

2020 ◽  
pp. 019459982095313
Author(s):  
Michael Shih ◽  
Linda Brock ◽  
Yi-Chun Carol Liu
Keyword(s):  
Foreign Body ◽  
Pediatric Population ◽  
Case Series ◽  
Primary Care Providers ◽  
Failure Rates ◽  
Care Providers ◽  
Success Rates ◽  
Foreign Body Extraction ◽  
Variable Success ◽  
Unclear Etiology

Objectives To compare the efficacy of aural foreign body (FB) extractions among medical care settings and determine if certain methods of extraction resulted in higher failure rates and procedural complications. Study Design Case series with chart review. Setting Emergency departments (EDs), urgent cares (UCs), pediatric primary care providers (PCPs), and otolaryngologists (ENTs). Methods A total of 366 pediatric patients with EAC foreign bodies at a tertiary children’s hospital and associated satellite clinics. Results The ED/UCs (17.46%), PCPs (75.22%), and ENTs (94.54%) exhibited highly variable success rates for pediatric aural FB extractions. Complications were considerably higher for attempts by ED/UCs (22.22%) as compared with PCPs (2.61%) and those of unclear etiology (2.73% of all attempts). Use of balloon-tipped catheters and adhesive-tipped probes (eg, cyanoacrylate/superglue) for FB extraction exhibited 0% success rates with high severity of complications. Conclusion Our statistics provide an example in which ED/UCs had higher failure rates at pediatric aural FB removals when compared with PCPs and ENTs. If a single provider (PCP or ED/UC) fails to retrieve an aural FB or if the provider is not comfortable conducting the procedure, then referral to an ENT is preferable to another PCP or ED/UC. Our evidence reveals that balloon-tipped catheters and adhesive-tipped probes for FB removal in the pediatric population are prone to failure and higher rates/severity of complications.

Pediatric Orthopedic Emergencies

2018 ◽  
Author(s):  
Priya Gopwani ◽  
Joy Koopmans
Keyword(s):  
Pediatric Population ◽  
Skeletal Development ◽  
Adult Population ◽  
Slipped Capital Femoral Epiphysis ◽  
Optimal Growth ◽  
Developmental Abnormalities ◽  
Osteoarticular Infections ◽  
Key Words Bone ◽  
Orthopedic Injuries ◽  
Pediatric Orthopedic

Proper care of orthopedic injuries and emergencies in children and adolescents requires knowledge of the altered bone and ligament characteristics, varying stages of skeletal development, and potential for congenital or developmental abnormalities. Pediatric fractures affecting the growth plate require unique management to maintain optimal growth. Whereas some specific fractures in these skeletally immature patients require urgent surgical repair, other fractures remodel extremely well and can be managed with a simple splint. Particular dislocations are common in this population and may have concomitant fractures. There are several overuse injuries seen primarily in children, and treatment aims to keep the patient active while allowing the injury to heal. Potentially devastating osteoarticular infections occur in the pediatric population and must be differentiated from more benign causes of joint pain, such as transient synovitis or congenital abnormalities. Children are also at risk for abnormalities such as slipped capital femoral epiphysis or Legg-Calvé-Perthes disease, which are rarely diagnosed in the adult population. It is imperative for a clinician to be aware of these and other nuances to optimally care for orthopedic injuries and emergencies in the pediatric population. Key words: bone, musculoskeletal, orthopedic, skeletal

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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