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  • Juliana Kilesse Carvalho
  • David W West MD
  • JULIO CESAR NEYRA PINTO
  • Kamel Mostafa

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I loved this review! I have a lot of Chlorosis in my practice! It jsut shows how what we perceive as reality is ever changing! Probably in a 100 years time the future doctors will look at the way we practice medicine and wonder how we could be so "o…
5 hours ago
Most of my patients have encopresis or pseudo incontinence. It is important and at the same time hard to have the parents understand that despite the perceived "diarrhea" the underlying problem is a fecal mass/constipation. An x ray helps, especiall…
5 hours ago
The best part is that the patient is doing well now.
6 hours ago
I agree. I've never seen it. It's a good one to add to the DDX.
6 hours ago
I often end up wording with GI to manage the children.
6 hours ago
the patient was 39 weeks old. Don't You think there are air leakage, very discrete in radiographs. there are 3 dates of x rays: second day, fourth day, and seventh day
7 hours ago
Reassurance and counselling is the traetment if proved to have no pathologic cause.
16 hours ago
Khalid Kamal, MD added 2 discussions
yesterday
The skull film especially is very classic for Langerhans Cell Histiocytosis. Very nice case!
yesterday
Julio - how many weeks gestational age was the patient, and what is the time interval between the chest radiographs? The radiographs are not classic for meconium aspiration - where we usually see hyperinflation and "ropey" appearing interstitial in…
yesterday
I have read about it but never seen a case myself. I suspect it will be more common as our patients continue to increase in size...
yesterday
Julio thanks for the update!
yesterday
JULIO CESAR NEYRA PINTO added a blog post
Hello, this is a 16 hours newborn with very critic respiratory disstress, who was born in a little town called Ilo two hours away from our city. Pediatrician refers apgar 3 and 5, does not withdraw blood, do not have arterial gases, tells us amnioti…
yesterday
2 weeks of fever with appropriate treatment. That is fascinating from a clinical standpoint. THank you Julio for the update.
yesterday
now we have ppd positive and she fulfills criteria for TBC, she is doing all rigth, she is receiving now antituberculous drugs. thanks for feedback
yesterday
i hasve prescribed him lactulose as his new way of living, but bot that simple, i have sent him to gastroenterology in order to make deeper studies on other rare possibilities.
yesterday
after two whole weeks the fever terminated, she was treated with ceftriaxone and ciprofloxacin, she is now with oral therapy in her house, very well.
yesterday
thanks a lot for feedback. i will call to lima and follow this case
yesterday
Also consider pollakiuria - Pollakiuria is defined as frequent daytime urination that may occur as often as every 5 minutes, although usually the child urinates 3-4 times/hour. This is a common pediatric complaint and the parents are usually concer…
yesterday
The National Cancer Institute publishes PDQ's (Physician Data Queries) which are summaries of all lastest treatments for various cancers. Divided by Adults/Pediatrics, Health Care Providers and Patients they are very good in my opinon for the lastes…
yesterday
 

Learning Portfolio Posts

JULIO CESAR NEYRA PINTO

meconium aspiration pneumonia

Hello, this is a 16 hours newborn with very critic respiratory disstress, who was born in a little town called Ilo two hours away from our city. Pediatrician refers apgar 3 and 5, does not withdraw blood, do not have arterial gases, tells us amniotic fluid is greenish. mouth and nose secretions were cleaned. Then this baby starts to breathe rapidly with retractions. So they sent him to our hospital. We receive this baby at 18 hours of life, with a first x rays it looks like meconium pneumonit

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Posted by JULIO CESAR NEYRA PINTO on March 10, 2010 at 10:08am — 3 Comments

Donna  D'Alessandro

What Causes Pharyngitis?

Story
A 7-year-old male came to clinic with a 4 day history of a sore throat. His mother reports that he also had some voice changes like laryngitis and some mild croupy sounding cough. That morning he came to the kitchen for breakfast crying almost inconsolably because he was in so much pain. The past medical history was non-contributory. The review of systems revealed no fever, chills, rhinorrhea, ear pain, headache, muscle ache, abdominal pain or rash.

The

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Posted by Donna D'Alessandro on March 8, 2010 at 12:30am — 2 Comments

JULIO CESAR NEYRA PINTO

histiocytosis

This is a 14 months old boy. his illness begins two months ago with loss of movement in his right arm and leg. their parents take him to "curandero" in order to heal him. One month after this empirical and unknown treatment they bring him to hospital. He is worse with tumor on his scalp and his rigth ear and otorragia.


On examination he has few adenopaties, no splenomegaly, his liver edge is palpated 1 cm under ribs. No petquias, no pale skin.


platelets 697000, INR 1.1, WBC coun

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Posted by JULIO CESAR NEYRA PINTO on March 7, 2010 at 2:55pm — 7 Comments

JULIO CESAR NEYRA PINTO

typhoid fever

She is a 5 years 6 months old girl. Her mother brings her to ER at 4 am before sunrise with a history of 2 days of loose stools, little appetite, nausea, abdominal pain. Last night she slept but was felt hot and moaning.


As most of us here in Peru, sanitation is poor, drinking water is scarce, hygiene education is low, this family also had dogs, cats, chicken inside their house. (not a farm, but downtown)


On initial examination she was febrile, her abdomen was distended, pain on

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Posted by JULIO CESAR NEYRA PINTO on March 5, 2010 at 11:20am — 6 Comments

Donna  D'Alessandro

Learning From the Past. What is Chlorosis?

Story

A pediatrician was reading for pleasure and came across this passage describing Mary Queen of Scots, just before her ascension as Queen of France when she was 17 years old in 1559:
"{England's ambassdor to France} Throckmorton also noticed that Mary was unwell and she soon had to retire from court in a state of nervous collapse. He found Mary and Henri's daughter, Marguerite, 'somewhat sickly' and on 24 May, visitors said she was 'very ill, pale and green and withal shor… Continue

Posted by Donna D'Alessandro on March 1, 2010 at 12:30am — 1 Comment

JULIO CESAR NEYRA PINTO

acute abdomen - fecal obstruction

He is a boy 12 years old, he arrives at our emergency room at 3 am moaning and crying with abdominal pain. His mother tells it just began last nigth, she automedicated him with no avail, he did not slept well and was asking for help, afterwards he commenced with vomiting, she says yellowish-greenish, so she decided to bring him to ER.


he was afebrile, crying, could barely walk, could not sit from recumbent position. his abdomen was hugely distended, asymetric, hard to plapate, highly t

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Posted by JULIO CESAR NEYRA PINTO on February 27, 2010 at 7:30pm — 5 Comments

JULIO CESAR NEYRA PINTO

tuberculosis neumonia and pleural effussion?

She is a girl 7 years old. Her mother says there are 5 days of illness characterized by fever, cough, left side pain, especially on breathing, and difficult breathing. She has complete inmunizations, no previous diseases. Her stools, urine are ok, her appetite decreased. In pediatric office they take an x rays (not available) which they report as total opacification of left lung, they send her to our hospital.


She is 25 kg, temperature 37.7 celsius, respiratory rate 33, pulse 130, oxim

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Posted by JULIO CESAR NEYRA PINTO on February 27, 2010 at 7:00pm — 5 Comments

Donna  D'Alessandro

What Causes Diurnal Enuresis?

A 4-year-old male came to clinic with a 1 week history of daytime enuresis. He was toilet trained for urine during the day for 9 months and used diapers at night, but over the past week often would have urinary incontinence. There was no dysuria or constipation but polyuria and polydipsia. The review of systems showed no weight loss, nausea, emesis, or fever. The family denied concerns of abuse.

The pertinent physical exam showed a well appearing male with normal vital sig

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Posted by Donna D'Alessandro on February 22, 2010 at 12:30am — 3 Comments

Donna  D'Alessandro

What is the Seroconversion Rate of Mumps Vaccine?

Story

A 16-month-old male came to the emergency room with a 2-3 day history of fever to 101° F. He had emesis 3 times over the first two days and his mother noted that he was somewhat fussier when eating but he had good oral intake and urine output. She also thought his left face was slightly swollen. There is documented mumps in his community and he was vaccinated with the measles-mumps-rubella vaccine (MMR) 1 month earlier. The pertinent physical exam revealed him to… Continue

Posted by Donna D'Alessandro on February 15, 2010 at 12:30am — 4 Comments

Khalid Kamal, MD

What is the ideal age for tongue tie repair?

Tongue tie is a common condition that we come across.


Sometimes frenuloplasty is done to help an infant breast feed better in the first few months of life.



More commonly, any procedure is deferred till the age of one year.



There is still some confusion about whether or not tongue tie needs to be corrected. Does the tongue tie really interfere with speech, swallowing? Can it lead to failure to thrive in extreme case

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Posted by Khalid Kamal, MD on February 11, 2010 at 10:08pm — 4 Comments

 
 

Forum

Khalid Kamal, MD

Fecal Incontinence in Children - A Review 2 Replies

Started by Khalid Kamal, MD. Last reply by eliana mckee 5 hours ago.

Khalid Kamal, MD

Omental Infarction in Overweight Children 2 Replies

Started by Khalid Kamal, MD. Last reply by Donna D'Alessandro 6 hours ago.

Khalid Kamal, MD

National Nutrition Month - March 2010. 3 Replies

Started by Khalid Kamal, MD. Last reply by Donna D'Alessandro Mar 3.

Donna  D'Alessandro

Are You a Vaccine Lumper or a Splitter? 3 Replies

Started by Donna D'Alessandro. Last reply by Donna D'Alessandro Feb 17.

 

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