Primary care
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Adverse childhood experiences are found in adults regardless of race, socioeconomic level, or education. They can be identified in a clinical environment by answering a retrospective questionnaire. Adverse childhood experiences are clearly linked to high-risk health behaviors and multiple chronic diseases. ⋯ Identification efforts have begun for children showing the prevalence and categories of abuse. National surveillance surveys capture prevalence data for children at the state level. The for Disease Control and Prevention has distributed prevention strategies to decrease the likelihood of adverse childhood experiences in children.
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In the pediatric population, asthma is the most common chronic disease. Asthma is a chronic inflammatory disease consisting of variable respiratory symptoms and airflow limitation. ⋯ Early diagnosis allows for earlier treatment and subsequent reduction of morbidity and mortality. Newer research and medications have changed the treatment paradigm, including the addition of biologic agents for more severe cases and use of inhaled corticosteroid-formoterol inhaler as a rescue treatment.
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The treatment of attention-deficit/hyperactivity disorder can be a very rewarding and challenging task. The management of this condition has impact on a child's performance in school in both academics and extracurriculars, and therefore, can be a determinant of what they are able to achieve and become. Treatment can also impact the child's self-image and ability to successfully interact with their peers. Adequate control of the disorder can break down barriers to successful development of a child's potential and ability to play a role in the work force someday.
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Pediatric hypertension is becoming of increasing concern as the incidence rate increases alongside pediatric obesity. Practitioners need to be aware of the screening recommendations for early recognition and management of this disorder. ⋯ Further work-up to rule out secondary causes of pediatric hypertension should also be considered in any child with stage 2 hypertension and in those with persistently elevated blood pressures. Early recognition and management are key to not only preventing present complications but also future cardiovascular disease in adulthood.
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Childhood obesity is a pathologic process with multifactorial causes. The reasons range widely. Obesity leads to chronic health conditions, increasing morbidity. ⋯ Medications and bariatric surgery may have a role in certain severe cases. Community and policy changes concerning food and physical activities may facilitate practical strategies against the increasing obesity epidemic. It will help families and health care systems tackle childhood obesity effectively.