Childhood Bereavement 12.20.2010

Huntsman Cancer Institute Brochure of Resources

Childhood Bereavement

Central Airway Obstruction

Central Airway Obstruction

Tracheoesophageal Fistulas

Tracheoesophageal Fistulas 12.15.2010

Wilms Tumor 12.13.2010

Wilms Tumor 12.13.2010

HUS 12.10.2010

Hemolytic Uremic Syndrome: The classical clinical triad for HUS microangiopathic hemolytic anemia,thrombocytopenia, and acute renal failure.
Pediatr Nephrol. 2008 Oct;23(10):1749-60. Review. PubMed PMID: 18704506

View my collection, "Hemolytic Uremic Syndrome (HUS)" from NCBI

Perscriptions...How to Help Families Save

Coming soon

Images Database

The Images database will allow you to search millions of scientific images from NCBI full text resources. You can search the Images database with terms or detailed search parameters, such as image height, width, and caption. The complete list of search fields is available from the Images Advanced search page. Image results initially display in a summary but may also ve viewed in a thumbnail display.

Congenital Adrenal Hyperplasia (CAH)

Congenital Adrenal Hyperplasia (CAH) 11.29.2010

Insulin Edema

Insulin Edema 11.24.2010

Meckel's Diverticulum

More to come....

View my collection, "Meckel's Diverticulum" from NCBI

T21 & Hydrops 11.19.2010

View my collection, "Nonimmune Hydrops Fetalis" from NCBI

Pelvic Inflammatory Disease 11.17.2010

View my collection, "Pelvic Inflammatory Disease" from NCBI

Psychosomatic Asthma 11.15.2010

Psychosomatic Asthma 11.15.2010

Child Care for Working Parents

Learn About Child Care, The Child Care Office at the University of Utah

Childcare 11.12.2010

Vaccinations 11.08.2010

View my collection, "Vaccinations 11.08.2010" from NCBI

Langerhans Cell Histiocytosis (LCH) 11.05.2010

Langerhans Cell Histiocytosis (LCH) 11.05.2010

Neuroblastoma 11.3.2010

View my collection, "Neuroblastoma 11.03.2010" from NCBI

Neruoblastnoma 11.03.2010

A Rash in the ED...What you do not want to miss

Morning Report 11/01/2010

Pustular Psoriasis
Staph
Stevens-Johnsons
Toxic Shock

Myth or Fact - Morning Report 10.20.2010

Know your facts...check out Baby Facts the book

Lupus 10.27.2010

14 y/o female, abdominal pain, oral ulcers and fever...

View my collection, "Lupus 10.27.2010" from NCBI

CATCH Grant for Residents

Dr Leah Costello presented the topic of her CATCH grant in a morning report presentation in June. It may be useful to use with parents of pre-adolescent and adolescent parents.

The Community Access to Child Health (CATCH) Resident Grant supports pediatric residents in the planning and/or implementation of community-based child health initiatives. Grants of up to $3,000 are awarded twice each year on a competitive basis for pediatric residents to address the needs of children in their communities.

CATCH Parent Class by Dr Leah Costello

Dermatomyositis

A 21/2 year old has a 6 month history of a papular rash and possible muscle weakness.

What is the usual age for dermatomyositis?
What is the criteria for clinical diagnosis?
What is the treatment?
What is the prognosis?

Dermatomyositis10.25.2010

Uncommon Manifestations of

Guillain-Barré syndrome could be:

• Pain
• Autonomic Neuropathy
• Facial Dysplasia

Links to more information:

National Institute of Neurological Disorders and Stroke

Guillain-Barré syndrome and Chronic Inflammatory Demyelinating Polyneuropathy

E-medicine

Guillain Barre Syndrome 10.22.2010

Cellulitis Diagnosis 10.15.2010

View my collection, "Morning Report - Oct. 15, 2010" from NCBI

Invasive Aspergillosis 10.01.2010

Invasive Aspergillosis, more to come...

Acute Chest Syndrome 09.29.2010

Sickle Cell and Acute Chest Syndrome more come...

Shingles in Pediatrics 09.27.2010

More to come

A 7 yo with chest pain and fever 09.24.2010

View my collection, "Pericarditis" from NCBI

Down There....09.21.2010

Presentation by Dr. Kristine Campbell on causes for vaginal bleeding in the pediatric patient.
Down There 09.21.2010

Early Detection of Children with Autism Spectrum Disorders 9.20.2010

View my collection, "Early Detection of Autism 9.20.2010" from NCBI

Autism Spectrum Disorders 9.20

CRP & PNA 09.17.2010

CRP and PNA 09.17.2010

Transverse Myelitis 09.15.2010

Coming soon...

Measles 09.13.2010

Koplik's Spots
Measles 09.13.2010

Serious Drug Reaction

Serious Drug Reactions 09.10.2010

Testicular Torsion

TesticularTorsion

Evans Syndrome 08.27.2010

Evans Syndrome 08.27.2010

Stroke 08.25.2010

Stroke 08.25.2010

Sturge Weber

A 5 month old is having a seizure as you walk into the room in the ED. What is the clue that is could possibly be Sturge Weber?
View my collection, "Sturge Weber Syndrome" from NCBI

Sturge Weber 08.20.2010

Where did the Blog Go?

I fell off the blog wagon this summer; not because I was on vacation, but because I was two people in the library all summer! But that all will change next week. A new librarian will be at the library. Her name is Dona and she just may show up at morning report sometime. Look for new search tips and a more up to date blog postings on interesting cases presented.

Neonatal Feeding Intolerance

presented by Gabrielle Zimbric

5 points:
1. Revise your Differential Diagnosis
2. Examine the patient (even if you are dealing with a cranky baby)
3. Don't fall for "the boy who cried wolf"
4. There is a wide differential for feeding issues
5. Nothing is ruled-out forever

Morning Report Feed Intolerance

View my collection, "Feeding Intolerance" from NCBI

Majocchi Granuloma 07.21.2010

Majocchi Granuloma

Mental Health Resources in Utah and beyond

For General Mental Health Information:
American Academy of Child and Adolescent Psychiatry
American Psychiatric Association
American Academy of Pediatrics
National Alliance on Mental Illness


Local Mental Health Resources

Systems Based Practice Resources Child Psychiatry

Systems of Care Psychiatry Websites

Chronic Diarrhea

More to come....

Kawasaki Disease

Occurs in 19 out of every 100,000 children in the United States.

Most children diagnosed with Kawasaki disease will have a fever lasting 5 or more days and at least four of these symptoms:

* redness in both eyes
* changes around the lips, tongue, or mouth
* changes in the fingers and toes, such as swelling, discoloration, or peeling
* a rash in the trunk or genital area
* a large swollen lymph node in the neck
* red, swollen palms of hands and soles of feet


View my collection, "Kawasaki Disease" from NCBI

Nontuberculous Mycobacterial Lymphadenitis

Nontuberculous Mycobacterial Lymphadenitis 07.09.2010

Last Day

To all the residents that had their last day of residency today:

I will miss seeing your beautiful faces at the library. Continue viewing the Morning Report Blog, we will post away. Have great adventures in your life after residency! Celebrate!

Parvovirus

Presented by Cindy Bader

* Most often presents as Erythema Infectiousum (5ths Disease)
* May lead to pregnancy complications
* Most prevalent among children 7-10 years of age

View my collection, "Parvovirus" from NCBI

Parvovirus

Barotrauma

A 14 year old comes into the clinic setting with ear pain that started after getting out of the swimming pool. The pain is described as a constant sharp pain, accompanied with intermittent ringing, light-headedness, and a change in hearing. Clear fluid is draining from the ear during the examination. After performing a Weber/Rinne tuning fork test and consulting with ENT a diagnosis of Perilymphatic Fistula is given and emergency surgery is required to correct the problem.

View my collection, "Barotrauma/Perilymphatic Fistula" from NCBI

Barotrauma 6.23.2010

For a detailed description of the Tunning Fork test use the search term Rinne in the search box below and go to the second search result. This reference is Glasscock-Shambaugh Surgery of the Ear, 5th edition, volume 1 found online through Google Books.

Rheumatic Fever

Presented by Tiffany Thomas

- In the US, the incidence is 2-14/1000 persons
- Most commonly occurs in children 5-15 years of age

Rheumatic Fever

View my collection, "Rheumatic Fever" from NCBI

Henoch-Schönlein Purpura (HSP)

View my collection, "Henoch-Schonlein Purpura (HSP)" from NCBI

A randomized, placebo-controlled trial of prednisone in early
Henoch Schönlein Purpura, BMC, 2004

Henoch-Schönlein Purpura (HSP)

The Mystery of a Very Sleepy Infant

Take home point:
Rather than using a sternal rub to arouse a sleepy or lethargic child, a more subdued method is holding the hand of the child and pressing the nail bed.


Intussusception 06.02.2010

Erythema Multiforme

Presented by Tiffany Milner

Patient: A 12 month-old has been referred to the Emergency Department by the PCP. She has a rash, fever, and swelling.

Diagnosis: Erythema Multiforme
More than 50% diagnosed are < 20 years-old

2 Types:

1) EM Minor
a) Little/no mucus membrane involvement
b) Vesicles, no bullae
c) No systemic symptoms
d) Usually involves only extremities and face

2) EM Major
a) Most often a drug reaction
b) Mucus membrane involvement
c) Extensive confluent bullae
d) Systemic symptoms (fever, prostration, chelitis)

View my collection, "Erythema Multiforme" from NCBI

Erythema Multiforme

Breakfast with Ed

May 7: Hiatal Hernia presented by Laura Duty
Hiatal Hernia 5.7.2010

May 5: Wilms Tumor presented by Megan Harrison

Learning point: A toddler presents to the ED after running into a parent's knee while playing. Is it a traumatic injury or something more? When pain is out of proportion to the injury there could be something more than a traumatic injury involved in the diagnosis.

Wilms Tumor 5.5.2010

April 30: Advocacy: Homeless Youth presented by Nate Ostheimer and Danielle Smith


April 28: Oven Cleaner Ingestion presented by Brook Lang

View my collection, "Ingestion of Caustic Agents" from NCBI

TOXNET a toxicology data network

Infant Hypocalcemia?

An infant has been referred to the Emergency Department by the PCP. The parents complain that the newborn (8 days of life) is twitching and has rapid eye movement. He does not seem to be getting better.

Differential Diagnoses:
Parathyroid, Hypocalcemia, Hypomagnesemia, Disorder of Vitamin D Metabolism.

View my collection, "Infant Hypocalcemia?" from NCBI

AM Report Hypocalcemia in Children

The Hypotonic Infant

Hypotonia Defined: decreased resistance to passive motion

* Patient: A 2-month-old female

* Setting: Outpatient clinic

* Chief Compaint: Mother is concerned her infant is not receiving adequate nutrients as the infant is constantly sleepy. She consumes approximately 1 oz per feeding requiring some sort of stimulation to keep her awake. The infant shows signs of hypotonia.

View my collection, "6 items" from NCBI

Hypodysplasia in Adolescents

An adolescent is brought into the ED for medical clearance based on reports of suicidal ideation . On exam he has high blood pressure and reports chronic epididymitis. Your main concern may be drug use based on medical history, but should you be concerned with the high blood pressure?

Take home points:

• Do not ignore high blood pressure. PediatricsinReview: Childhood Hypertension
• For urinary tract history combined with high blood pressure order an ultrasound upon admission to rule out emergent kidney issues and possible obstruction.
• A quick link to GFR Calculator, Original Schwartz Equation (for use with routine creatinine methods that have not been recalibrated to be traceable to IDMS).

Salmonella Gastroenteritis 04.21.2010

Salmonella Gastroenteritis 04.21.2010

'He's bisexual, what do we do?'

Sexual Orientation: An individual pattern of physical and emotional arousal toward other persons (American Academy of Pediatrics).
Sexual Orientation 1



View my collection, "Sexual Orientation" from NCBI

Acute Cerebellar Ataxia

Acute Cerebellar Ataxia

Topics of late March Early April

March 31: Pediatric Thrombosis presented by Scott Carleton, MD



April 2: Miller Fischer Variant Guillain-Barre presented by
Melissa Hathaway, MD
View my collection, "Miller Fischer Variant Guillian-Barre" from NCBI
Miller Fischer Variant Guillain-Barre

DRESS

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rather distinct severe adverse drug reaction characterised by skin rash, fever, lymph node enlargement and internal organ involvement.

View my collection, "DRESS" from NCBI

patient presentation

A 9 month old comes in with a gaping mouth... After a neurology consult and still no diagnosis, what can it be?

During your child's dental checkup, the child's dentist might check for signs of temporomandibular joint syndrome (TMJ). Although TMJ is typically thought of as an adult disorder, children can exhibit early symptoms.

TMJ: Not Just for Adults- Temporomandibular Joint Syndrome

View my collection, "TMJ " from NCBI

Understanding Medical Research

Statistics for the non-statistician
Part I: Different types of data need different statistical tests.
Part II: "Significant" relations and their pitfalls.

Series on Evaluation of Scientific Publications from Deutsches Ärzteblatt International the German Medical Association’s official international science journal—is a weekly, peer-reviewed, open-access online journal of clinical medicine and public health.

Part 1: Critical Appraisal of Scientific Articles Series

Part 2: Study Design in Medical Research

Part 3: Types of Study in Medical Research

Part 4: Confidence Interval or P-Value?

Part 5: Requirements and Assessment of Laboratory Tests

Part 6: Systematic Literature Reviews and Meta-Analyses

Part 7: Descriptive Statistics: The Specification of Statistical Measures and Their Presentation in Tables and Graphs

Part 8: Avoiding Bias in Observational Studies

Part 9: Interpreting Results in 2×2 Tables

Part 10: Judging a Plethora of p-Values: How to Contend With the Problem of Multiple Testing

Part 11: Data Analysis of Epidemiological Studies

March Blew By

I would like to thank my blog buddy, Gena Lattin, for her timely postings. I, on the other hand, have a little catch up to do for March morning reports. How is it that February can be the longest month with the least amount of days, but March is just about over and it has 31 days?!

March 17th: Breakfast with Ed.

March 19th: Hyponatremia in Children by Eric Spiegel
Recomended article:
Hyponatremia in Children
Robert C. Kelsch and William J. Oliver
Pediatr. Rev. 1980;2;187-190

View my collection, "Hyponatremia in Children" from NCBI


Hyponatremia in Children 03.19.2010



March 24:


March 26: Healthcare Reform. Do you understand it? How will it impact the practice of medicine?
HealthReform.gov
Health Care Reform 101
Consumers Guide to Health Reform
American Medical Association: Impact on Practice
American Academy of Pediatrics Supports Health Reform

What disease goes unrecognized 2/3 of the time?

Pelvic Inflammatory Disease: PID Fact Sheet


View my collection, "Pelvic Inflammatory Disease (PID)" from NCBI

Group B Streptococcal

View my collection, "Group B Streptococcal" from NCBI

Temper Tantrums and Behavioral Management

View my collection, "Temper Tantrums and Behavioral Management" from NCBI

Temper Tantrums


Other resources:

* SOS Help for Parents by Lynn Clark, PhD
* Development Behavioral Pediatrics: A Handbook for Primary Care. 2nd edition 2005Parker et al.
* Encounters with Children: Pediatric Behavior and Development. 4th edition 2006. Dixon, S. and Stein, M.
www.healthychildren.org

Vomiting

View my collection, "Vomiting" from NCBI

This article about recurrent vomiting in children was in the British Medical Journal in 1905. See if you can discern any differences between then and now...

Advocacy: Helmet Use in Preventing Injury in the Alpine Environment

Lids on Kids

Helmet Use in Preventing Injury in the Alpine Environoment

Hodgkin's Lymphoma

View my collection, "Hodgkin Disease" from NCBI

Intracranial Complications of Sinusitis

Presented by Nisha Ray-Baur, February 26, 2010.

An 11 year old presents with tactile fevers, headache, and an altered mental state, the patient is confused and does not know who he is. The diagnosis: Subdural empyema.

For Additional Resources, View my collection, "Subdural Empyema" from NCBI

Intracranial Complications of Sinusitis

Adenovirus...The Great Imposter

Morning Report topic presented by Irene Kocolas on 02.24.2010

Additional Resources:
View my collection, "Adenoviral Infections" from NCBI

Red Book Online: Adenovirus (Requires a subscription available at Intermountain)
Adenovirus

A 49 day old comes in "bright yellow" in color...

View my collection, "Biliary Atresia" from NCBI

Branchial (Cleft) Cysts

View my collection, "Branchial Cysts" from NCBI

Branchial (Cleft) Cysts

Endocarditis

Important take away points made by Marcus Blackburn, who presented on February 17, were:

1. Blood cultures should be obtained prior to antibiotic therapy if possible. Blood culture-negative endocarditis in a reference center: etiologic diagnosis of 348 cases.
2. Multiple blood cultures should be performed over time. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service.

View my collection, "Endocarditis" from NCBI

Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America.

Breakfast with Ed

Wednesday, February 10 was breakfast with Ed. I thought today I would catch up with a few of the Morning Report topics that were not posted in a timely fashion these past two weeks.

Wednesday, January 27.
A six month old female with fever, irritability and a upper respiratory infection...but was that all?

View my collection, "Kawasaki Disease" from NCBI

Wednesday, January 29.
Advocacy: Vaccinations and How to Answer Parents Concerns. Knowing the facts can help you answer questions that come up.

Resources:
American Academy of Pediatrics -- Thimerosal Speaking Points

Good reads:
The Vaccine Book by Sears, RW
Autism's False Prophets by Offit, PA
Louder than Words by McCarthy, J.

Article to review:
View my collection, "Vaccines" from NCBI

Wednesday, February 3.
View my collection, "Aplastic Anemia" from NCBI

Friday, February 5.
COP-cryptogenic organizing pneumonia
(AKA BOOP--bronchiolitis obliterans organizing pneumonia)
View my collection, "BOOP--Bronchiolitis Obliterans Organizing Pneumonia" from NCBI

A one month old comes in with a broken leg...

Is it abuse or is it something else?

View my collection, "Bone Health_Vitamin D" from NCBI

Neonatal Subgaleal Hemorrhage

Characteristics:
* Fluctuating
* Boggy
* Persists after 24 hrs
* Elongated Head
* Gravity Dependent
* Shifts with movement

View my collection, "Neonatal Subgaleal Hemorrhage" from NCBI

Attachment Disorder

AACAP_Reactive Attachment Disorder
View my collection, "Attachment Disorders" from NCBI

Attachment Disorder[1]

Chylothorax in a Neonate

View my collection, "Chylothorax" from NCBI

PubMed Tip: If you would like to search for a term like 'Chylothorax' but you do not want to view citations about 'congenital chylothorax' you may enter your search as 'Chylothorax NOT congenital'. Adding the Boolean term NOT will help elimnate unwanted terms in a search. Make sure to capitalize all the letters in NOT as PubMed recognizes AND, OR and NOT as Boolean search terms otherwise they may be eliminated as stop word in a search string.

JAMA Users' Guides to the Medical Literature

Today was a breakfast from the usual morning report process. Therefore, without a morning report presentation to post, I would like to share with you a different resource that can be found in JAMA: the journal of the American Medical Association. I learned about this series from Dr. Kristine Campbell. The resource is a series of brief articles that have been titled 'Users' Guides to the Medical Literature'. These users' guides were developed to provide tools for clinicians to search for and evaluate the medical literature to solve real patient problems. If you would like to learn more you may start with the editorial on the Users' Guides to the Medical Literature. Intermountain has full-text online access to JAMA from 1998 to the present. Currently there is not remote access for Intermountain, however the Eccles Health Sciences Library at the University of Utah does have remote access.

Once you view the collection below in PubMed you may order the articles by title to view them in the order they were published.

View my collection, "JAMA Users' Guides to Medical Literature" from NCBI

The sources of lead exposure may surprise you...

• Ceramics
• Paint
• Jewelry
• Stained Glass
• Make-up (foundation/lipstick)
• Candy from MX
• Canned goods

Lead Free Kids, Lead Safe Housing Program

View my collection, "Lead Exposure" from NCBI

Retropharyngeal Abscess

Retropharyngeal Abscess 01.06.10 by Robyn Nolan MD

Immune Thrombocytopenia (ITP)

A typical platelet count in a healthy person is between 150,000 and 450,000 per microliter of blood; you have a child that comes in with a platelet count of 5... Something seems drastically wrong with that picture.

View my collection, "ITP" from NCBI