Pediatric clinics of North America
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Bedtime struggles, delayed sleep onset, and problematic night wakings are extremely common in the pediatric population, and have a significant impact on quality of life of both children and caregivers. This article reviews the research and clinical nosology of childhood insomnia, prevalence, and etiologic factors in infants, children, and adolescents. ⋯ Insomnia in special populations, particularly children with chronic medical, psychiatric, and neurodevelopmental disorders, is discussed. Future directions in childhood insomnia are presented.
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Pediatr. Clin. North Am. · Feb 2011
ReviewPharmacotherapy for child and adolescent attention-deficit hyperactivity disorder.
Research in the past 2 decades showed that attention-deficit/hyperactivity disorder (ADHD) is a frequently occurring psychiatric disorder that causes considerable suffering to patients and their families. This article outlines current pharmacologic ADHD treatment options and focuses on their safety profile and efficacy. In addition, it addresses treatment selection, guidelines for monitoring treatment, and recent controversies in the field.
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This article discusses pneumothorax, pneumomediastinum, and pulmonary embolism in pediatric practice. Although children appear to have better outcomes than adults, the risk factors are substantial. Topics covered include the pathophysiology incidence, presentation, diagnosis, and management of these diseases.
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Children frequently present to a pediatric office or emergency department with the complaint of chest pain. Between 0.3% and 0.6% of visits to a pediatric emergency department are for chest pain. ⋯ Infrequently, a child with chest pain will present with significant distress and require immediate resuscitation. Most children with chest pain are not in extremis, and for many, the pain is not acute in nature.
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Musculoskeletal chest pain is the most common identifiable cause of chest pain in children and adolescents. A lesion or irritation of any layer of the anterior chest wall may lead to pain. ⋯ Regardless of the cause, chest pain raises concern of cardiac abnormalities, and may rapidly lead to significant anxiety and lifestyle alterations. Thus, efficient and accurate identification of the cause of pediatric chest pain by a thorough history and physical examination is important to minimize the disruption it may cause.