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Archive for the ‘Pediatrics & Children’s Health’ Category

Children may develop a form of hyperthyroidism specifically called pediatric hyperthyroidism. Although the symptoms are more or less the same with the adults, there has been much more controversy surrounding the treatment of this condition in children. Graves’ disease is usually one of the common culprits of the excessive thyroid hormone production in pediatric cases so this bears watching.

Antithyroid Drugs

Antithyroid drugs work in several ways from blocking the oxidzation of iodine to reducing the rate of iodide trapping. Most common in this category of drugs are propylthiouracil and its similar compounds methimazole and carbimazole.

Patients with hypersecreting thyroids may be treated with the drugs above to prevent the formation of thyroid hormone from tyrosine and iodine. This is one of the most commonly used treatments for children and a study reports the achievement of long-term remission with the use of antithyroid drugs alone following a mean treatment duration of around 3 years.

Block-replacement is another method which utilizes high doses of antithyroid drugs with subsequent replacement of iodine is more convenient than the titration regimen. Block-replacement usually requires around 3 hospital visits a year, whereas the titration regimen could require twice more.

Radioiodine

The thyroid gland normally takes up about a fifth of the ingested iodides. This happens because of an active pump in the thyroid cells that effectively trap the circulating iodides in the bloodstream into the thyroid. These iodides are then oxidized and then bound to the tyrosine residues inside the thyroglobulin molecule inside the gland.

However, if the iodine that has been absorbed by the thyroid gland possesses some degree of radioactivity, this could kill the hyperactive thyroid cells rather efficiently. This method has been used in place of levothyroxine methods but it is not without its hang-ups. A possible risk of the use of radioiodine is the development of extrathyroidal carcinoma or cancer in other tissues aside from the thyroid. This treatment can also cause hypothyroidism in patients so the dose must be carefully considered.

Surgery

Before the development of radioiodine and other antithyroid drugs, surgery was the easiest way to treat hyperthyroid patients. This procedure entails the complete or partial removal of the thyroid gland through surgical means and patients are usually given this option when they fail to respond favorably to other forms of treatment.

Prior to the development of modern pre-operative procedures, the mortality of thyroid surgery was as high as 1 in every 25 operations. Now, this has been reduced to around 1 in 1000 operations only.

Weeks or months prior to surgery, the patient must be treated with propylthiouracil or its similar compounds until such time that his metabolic rates return to normal. Then, one to two weeks immediately before the operation, high doses of inorganic iodides are administered to the patient. This reduces the swelling of the thyroid gland, which makes for a smaller surgical cut. The latter also diminishes the blood supply of the thyroid, which means there will be less bleeding.

In treating cases of pediatric hyperthyroidism, it is necessary that the family be advised properly on the possible outcomes and risks involved in each treatment. The family must also know the processes involved in each treatment. It is the duty of the physician to inform the family of their patients on the available treatments for this condition and aid them make better choices for their children.

An Electronic Medical Record system is an integral part of Pediatric healthcare practices. A specialized EMR system serves all the needs of a Pediatrician. To know more about it, first we need to know what an EMR is.

Children are special patients. Each and every growth, changes in body and problems are to be medically comprehended and monitored to provide best treatment. Pediatricians have to access a varied range of pediatric medical charts to calculate the BMI or the Body Mass Index and the growth patterns of a child’s body. Pediatric Specific EMR Features include:

o Immunization and health maintenance reminders for better treatment
o Document/Image Management
o Online Patient portal
o Specific Pediatric dosage calculations
o Client/Server or ASP based
o E & M based coding assistance
o Computer based management of Documents and images
o Child growth chart (electronic)
o Prescriptions (PDR based)

And a variety of other Pediatric based EMR features.

Acclaimed EMR retailer:

RevenueXL brings to you experienced, proven and best Pediatric EMR software in the market. This EMR software is imbued with a variety of features which makes the Pediatrician’s clinical methods far more automated and easier and helps in providing better clinical services to patients. The software from RevenueXL software runs E & M coder and super bill which are specialized features of Pediatric solutions. The EMR software can be customized to meet the Pediatrician’s needs.

Features of Pediatric EMR software:

o Categorization of Child examination charts according to age and gender to make vaccination and other immunizations easier to track and remember.
o X-rays, ultrasonography, MRI, ECG and other medical images can be stored into electronic charts and can be accessed at just a click. Medical notes can also be created and stored along with these to make monitoring easier.
o Consent forms can be printed out and electronic signature of the patient can also be taken easily.
o Schedule, appointments and billing can be done easily with the EMR software.
o Doctors’ handwriting is very illegible. If you are tired of the chemist asking you to read it out, this software with prescription writing will be a great help. The prescriptions can be faxed or emailed to the pharmacy directly.
o Electronic and integrated dosage calculator makes medicine dosage comprehensive and easier.

Pediatric EMR templates

Customized pediatric templates (specific to different division of medicine) include the following -

o Abdominal pain templates
o Conjunctivitis templates
o Food poisoning templates
o Appendicitis templates
o ENT (ear, nose and tongue) templates
o Viral fever templates
o Sick child exam templates
o Growth chart templates

Contact today itself for customized solutions for pediatric treatments. We assure you all sort of integrated solutions for specific pediatric problems.

Generally, urology deals with urinary tract diseases, kidney diseases and anatomical abnormalities. These problems occur to adults as well as to children. If your child suffers abdominal pain and irregular or hard urinating experience, your child have these problems so immediately look for best pediatric urologist doctors. These medical practitioners had an extensive training on urologist as well as on child care. They can surely diagnose your child’s sickness and provide treatment as well.

Being a parent, who always look for the best even in this circumstances we want to get the best pediatric urologist doctor for our child. All of the professionals in the medical world are known to be experts but still some of them stand out, and these some are what we are looking for.

Here are some guides for you to find the best pediatric urologist doctors; first, the urologist must have the ability to connect with patients on a personal level. This is necessary especially because the physician will be dealing with kids. He must have the ability to handle your child’s attitude and treat him with compassion and care. He must be able to put patients at ease with a comforting personal approach. The next thing that you have to look for is the doctor’s education because you have to find the one who has an ongoing education aside from what he had on the medical school. Trainings and additional studies will make him more able to cure your child’s disease. The role of urologist does not end after his treatment of your child’s disease, but rather it should last. Look for the pediatric urologist that knows how to develop long lasting relationship wit patients because doctors with this attitude have the goal to make lasting improvements on your child’s health. Anytime your child’s disease reoccurred you have someone to turn o and get the treatment that your child deserves.

If you see these things in one of the pediatric urologist near in your area don’t hesitate to ask him to be your child’s doctor. He is surely devoted on his profession and his attention will be centered on your child assuring his immediate treatment and recovery. He will surely find the best solution for your child’s condition to get him back to his feet fast.

But if you can’t find a pediatric urologist in your area, the internet is always available for you to find one. Some websites can locate the best pediatric urologist doctors that you are looking for. The internet is a reliable source because the best doctors that it will recommend can show credentials together with their good rapport, experience in the practice and other proof to ensure their reputation and expertise on kidney diseases and anatomical disorders. To find one, go online and make a few clicks and you will surely find the best pediatric urologist in town.

Ear infections are the most common ailment among children, with 10 million new cases per year. Accounting for over a third of all pediatric visits, it is one of the most painful conditions a child may face. Statistically, nearly half of all babies will experience middle ear infection during their first year of life. By the age of 3, at least two-thirds of all children will have experienced it.

Ear infections (also known as otitis media) can be viral or bacterial. Irritability, fever, and pain are among the reported symptoms. Often, it follows or accompanies another illness, such as a common cold or sinusitis. Ear infections after a complication of the common cold or other illness have an easier time developing since normal resistance to infection is low. In the same way that emotional stress affects the immune system, physical stress on the central nervous system reduces our resistance to illness.

In some cases, ear infections could turn into a chronic condition that may require regular treatment. Once chronic, it may present a risk of serious hearing loss, as well as developmental and speech problems.

Common Ear Infection Treatment
Conventional treatment relies on the use of antibiotics. Antibiotics may prove effective in cases where the condition is bacterial in nature. Research has shown that, in the best sense, antibiotics are comparable to the body’s own immune system. Regular use of antibiotics, however, may cause the body to produce drug-resistant bacteria. In this case, antibiotics will not only do nothing to address the actual virus, it will also do little to relieve the pain. It can also increase the risk of reoccurrence.

For children under the age of 2, ear infections are the second most often performed surgery. Severe cases may also require “ear tubes,” in the form of tympanostomy or myringotomy. These drastic methods are used in such cases as when fluids persist in the ear and the patient’s hearing is affected.

These tubes relieve ear pressure and diminish buildup of fluids by allowing fresh air to flow through. The method can be effective, but 20 to 30 percent of these surgeries have to be repeated. If the infection is still present after surgery, adenoidectomy (the surgical removal of the adenoids) could be recommended. When a child undergoes these surgeries, general anesthesia is used.

An Alternative Treatment: How Chiropractic Can Help
Other than using antibiotics and resorting to surgery (ies), some parents are looking to alternative methods of addressing their child’s ear infections. Various studies have shown that otitis media were improved with chiropractic care. A study conducted by the National Institute of Health had the following results: 93% of all episodes were improved with chiropractic adjustments, and 43% with only one or two treatments. Factors such as no history of antibiotic use and young age were linked with the fewest required treatments. The study’s data concluded there were limitations of medical intervention and that chiropractic care may reduce the symptoms of children’s ear infections.

For the study above, a Sacral Occipital Technique of pelvic blocking and the doctor’s form of modified applied kinesiology were used. The regimen consisted of three treatments per week for 1 week, then two per week for 1 week, followed by one treatment per week. Treatments were discontinued once the symptoms improved.

For the treatment of ear infections, doctors of chiropractic focus on upper-cervical manipulation, with particular emphasis put on the back of the skull, or the first vertebra in the neck. Adjustment on the back of the skull (occiput) helps to drain the middle ear. Chiropractors aim to mobilize fluid drainage, encouraging the buildup of the child’s own antibodies.

In severe cases, chiropractic adjustments are initially made on a regular, if not daily, basis. Progress is monitored using a tympanogram to see how well the fluid is draining.

Overall, chiropractic care for children relies on adjustments that allow the child to fight off ear infections. Once a child can develop their own resistance to them, the ear is often able to recover on its own. However, when extra factors such as exposure to smoke or an abnormally shaped Eustachian tube is present, the problem may more difficult to treat.

Speak to your chiropractor about ear infection treatment. He or she will employ a gentle, age-appropriate form of treatment for your child.

Bronchitis is a respiratory problem which can be found in the lower tract. It occurs when there is an inflammation of the airway tubes that include the trachea and larger air tubes that carry oxygen to the lungs.

There are two types of bronchitis infections: acute and chronic.

Followed by viruses, acute infections usually bother the nasal passages, sinuses, and throat and then going to the larger tubes. Sometimes bacteria cause the infection.

When parents smoke around their children, the kids are likely to get sick with bronchitis much easier than those not around smoke. Children who have a pre-existing condition or heart disease are also at risk.

Chronic bronchitis is produced by an overabundance of mucus that causes a productive cough. Until the infection is cleared, it progresses into a constant inflammation that can hinder the stream of air. It can also cause serious damage of the tract.

COPD (Chronic obstructive pulmonary disease) is a respiratory problem that can cause long time issues for the patient in doing physical activity and normal breathing.

The main culprit for kids is the constant, long-term exposure of smoking. Sometimes allergies and environmental irritants can be troublesome for them too.

What are the symptoms?

For children, preventive measures need to be taught earlier. Kids need to know to cover their mouths when they sneeze or cough. They also need to continuously wash their hands. Kids also need a flu vaccine to help them fight any type of breathing problems. If the parents or grandparents can stop smoking, this would be beneficial for the children too.

Both types of infections have similar symptoms:

* Tires easily
* Wheezing
* Difficulty breathing worsened by physical exertion
* Mucus filled cough (if there is any blood in the mucus, then consult in the child’s physician.
* Rales (these are abnormal sounds that are found in the lungs by the doctor.)

There are several tests that can be used to diagnose children’s respiratory problems. They include: x-rays, pulse oxymetry, pulmonary lung functions, arterial blood gas and sputum.

If it’s left untreated, the infection can develop into more serious respiratory infections that include pneumonia, pulmonary hypertension, heart failure on the right side as well as emphysema.

When it seems there is no infections, doctors will treat the child for a common cold. This means staying in bed, drink lots of fluid. Using a humidifier can help the child get over the cold much quicker. If the child experiences dry cough, it would be necessary to use a cough suppressant for their own comfort. Aspirin is a no-no for children because of the danger of Reye’s syndrome. Tylenol or Motrin should be the only two medicines parents should use.

Sometimes to get the mucus moving, doctors may suggest using expectorants. These types of medicine will thin the mucus out, which makes it easier to get rid of quicker. Before doing this, consult the pediatrician.

Antibiotics will only be prescribed for bacteria related bronchitis. Like adults, children need to take the medicine as directed to avoid recurrences. Children under age 8 will be given Amoxicillin instead of other types of medicines.

As for chronic problems, treatment depends on how far into the disease you are. Children need a healthy environment and supervised exercise. Some medications can be used to relieve the stress on the bronchial tubes thus allowing air to flow through.

Preventive measures are always better than a cure. Parents who smoke need to remember that when they smoke so do their children who in turn also face health problems.

There is currently concern about a growing shortage of physicians of all specialties in the US. The bulk of the population in the US is the “baby boom” generation which is now entering retirement age. There are several problems that may develop as a result of this, the number one being that there may be more physicians retiring than there are finishing residency and the second is that this larger older population will need more care than it did when younger. Of course, Pediatrics has a different dynamic that adult medical care, but the choice of specialty caused by greater demand of other specialties and the mini boom in population of children born between 1981 and 1995 is causing a shortage for Pediatric care as well.

SHORTAGE

Recent studies report a shortage of pediatric surgeons in the United States. American Pediatric Surgical Association survey of members estimates current workforce and demand and to provide data for workforce planning.

The shortage of pediatricians trained in specialties such as neurology, gastroenterology, and developmental and behavioral medicine threatens timely access to care for children. Even as early as 1997 the National Institutes of Health suggest that the job market for newly trained residents in primary care pediatrics has tightened.

Recruiters experience the pains of their clients when seeking out quality physician candidates on their behalf. Statistically, we have found the pool of pediatric surgeons dismal at best, due to the incredibly high demand, with nearly one in four practices seeking additional surgeons. In addition, pediatric gastroenterologists and pediatric neurologists, particularly epileptologists, have proven challenging to source with more opportunities than physicians available in the marketplace. The good news for fellows completing their training is that the demand for their expertise remains high.

DELAY RETIREMENT

Between the recent stock market and real estate collapse many older physicians are remaining in practice longer than Planned In some specialties this has led to fewer high quality positions available to the oncoming new generation of physicians. According to the APSA, some surgeons plan to delay retirement, because it would leave their group or community shorthanded. However, the shortages are such that this appears not to be the case for pediatricians.

INCREASED DEMAND

The demand for pediatric sub-specialists is continuing to increase for the following reasons:
* More Educated consumers requesting sub-specialists for treatment
* Increased obesity rates among children
* Fellowship programs not meeting the current mini boom in population of children

Many general pediatric residents are pursuing pediatric subspecialty training. The number of subspecialty training openings has not adequately increased during this last decade.

GROWING INCOMES

Incomes have grown, As a result of this shortage, outpacing other medical specialties. According to the MGMA Physician Compensation and Production Surveys pediatric sub-pecialists are reaping the rewards of heightened demand with an increase in compensation. For one of the first times, pediatric surgeons actually earn more than adult surgeons.

HEALTH CARE REFORM During the healthcare debate, pediatric groups lobbied to secure more funding for training and higher reimbursement for pediatric sub-specialties, in the hope of encouraging more doctors-in-training to enter the field. Specialization typically requires up to three years of training beyond a general pediatrics residency and can pay salaries less than half the rate of adult specialty medicine.

The hospitals also reported that jobs for the top specialties are going unfilled for a year or longer; nearly half reported vacancies in pediatric-rehabilitation medicine, hematology and oncology, and cardiology. For families, that often means waiting for months to see a specialist and incurring heavy travel costs, often to another state.

HIGH COST OF EDUCATION

The Senate bill contains a measure that would fund a loan-forgiveness program for pediatric sub-specialists, easing the financial burden of medical-school costs. The federal Medicare program funds training programs for adult medicine. Congress five years ago authorized funding for pediatric specialty training, but the funds must be re-authorized every year.

One problem is that specialists tend to cluster close to large academic medical centers, in areas where there is a population large enough to sustain a practice. American Academy of Pediatrics found that while the greatest shortages are in rural areas, the majority of general pediatricians in all geographic areas considered wait times to be excessive when referring patients to sub-specialists.

To cope with the problem, many hospitals are turning to strategies such as telemedicine-remote consultations using two-way video systems-and mobile vans that may drive hundreds of miles to set up clinics in under-served areas. Hospitals are also more often turning to adult specialists to treat children, though not all are willing to do so. Surgeons, for example, may refuse to operate on children, because they aren’t trained to deal with the differences in their physiology.