FP essentials最新文献_第3页

Musculoskeletal Issues in Children and Adolescents: Adolescent Idiopathic Scoliosis. 儿童和青少年的肌肉骨骼问题：青少年特发性脊柱侧凸。

FP essentials Pub Date : 2024-09-01

Julie Creech-Organ, Jeffrey C Leggit

引用次数: 0

Musculoskeletal Issues in Children and Adolescents: Common Childhood Musculoskeletal Injuries. 儿童和青少年的肌肉骨骼问题：常见的儿童肌肉骨骼损伤。

FP essentials Pub Date : 2024-09-01

Jacqueline L Yurgil, Jeffrey C Leggit

引用次数: 0

Musculoskeletal Issues in Children and Adolescents: Genetic Musculoskeletal Disorders. 儿童和青少年的肌肉骨骼问题：遗传性肌肉骨骼疾病。

FP essentials Pub Date : 2024-09-01

Francis G O'Connor, Jeffrey C Leggit

{"title":"Musculoskeletal Issues in Children and Adolescents: Genetic Musculoskeletal Disorders.","authors":"Francis G O'Connor, Jeffrey C Leggit","doi":"","DOIUrl":"","url":null,"abstract":"Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic disorder with progressive proximal weakness as the principal sign. Glucocorticoids and physical therapy are the mainstay of treatment. Exercise intolerance is the hallmark of metabolic myopathies, which require a combination of laboratory testing, electrodiagnostic testing, and muscle biopsy for diagnosis. Joint hypermobility may be an isolated finding or be associated with hypermobility Ehlers-Danlos syndrome (EDS), other variants of EDS, or marfanoid syndromes. The latter conditions are associated with aortic and cardiac valvular abnormalities. Osteogenesis imperfecta encompasses a group of disorders characterized by bone fragility presenting with a low-impact fracture as a result of minimal trauma. Management includes multidiscipline specialists. Down syndrome (DS), or trisomy 21, is the most common chromosome abnormality identified in live births. Routine evaluation of atlantoaxial instability with x-ray is no longer recommended for children with DS without symptoms of atlantoaxial instability; however, clinical evaluation of symptoms is required for sports preparticipation. Achondroplasia is the most common skeletal dysplasia. Clinical signs are macrocephaly, short limb, short stature with disproportionately shorter humerus and femur, along with characteristic findings in pelvis and lumbar spine x-rays. Caregivers should be educated on proper positioning and handling to avoid complications, including car seat-related deaths.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"544 ","pages":"12-19"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Musculoskeletal Issues in Children and Adolescents: Abnormal Findings on the Newborn Musculoskeletal Examination. 儿童和青少年的肌肉骨骼问题：新生儿肌肉骨骼检查异常发现。

FP essentials Pub Date : 2024-09-01

Jeffrey C Leggit, Julie Creech-Organ

引用次数: 0

Musculoskeletal Issues in Children and Adolescents: Foreword. 儿童和青少年的肌肉骨骼问题：前言。

FP essentials Pub Date : 2024-09-01

Kate Rowland

引用次数: 0

Renal and Urinary Conditions: Urinary Tract Infections. 肾脏和泌尿系统疾病：尿路感染

FP essentials Pub Date : 2024-08-01

Darrell Edward Jones

{"title":"Renal and Urinary Conditions: Urinary Tract Infections.","authors":"Darrell Edward Jones","doi":"","DOIUrl":"","url":null,"abstract":"Urinary tract infections (UTIs), including cystitis and pyelonephritis, are common. Each year, they account for more than 10 million outpatient visits and more than 3 million emergency department visits. Recurrent UTIs (defined as three in 1 year or two in 6 months) also are common, occurring in 20% to 30% of women. The annual incidence of UTIs is 12.1% among women and 3% among men. Cystitis symptoms include lower abdominal pain, dysuria, and urinary urgency or frequency. Escherichia coli is the most common pathogen. Cystitis often is diagnosed inappropriately when patients have asymptomatic bacteriuria (ie, positive urine culture result without symptoms). This can result in unnecessary antibiotic therapy. For uncomplicated acute cystitis in women, guidelines recommend nitrofurantoin for 5 days, trimethoprim-sulfamethoxazole for 3 days (if local drug-resistance rates are less than 20%), fosfomycin in a single dose, or pivmecillinam for 5 days. Effective prophylactic options for UTI include antibiotics and vaginal estrogen for postmenopausal women. Antibiotics are most effective but are associated with a risk of increased drug resistance. Patients with pyelonephritis present with costovertebral tenderness, fever, and urinary symptoms. Third-generation cephalosporins are preferred for management. Significant complications of pyelonephritis include sepsis or septic shock, obstructive pyelonephritis, emphysematous pyelonephritis, perinephric abscess, and kidney transplant rejection. For pregnant patients with pyelonephritis, hospitalization and intravenous antibiotics are indicated.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"543 ","pages":"24-34"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal and Urinary Conditions: Kidney Cysts and Tumors. 肾脏和泌尿系统疾病：肾囊肿和肿瘤

FP essentials Pub Date : 2024-08-01

Stephanie J Sexton

{"title":"Renal and Urinary Conditions: Kidney Cysts and Tumors.","authors":"Stephanie J Sexton","doi":"","DOIUrl":"","url":null,"abstract":"Kidney cysts and tumors often are identified during imaging for unrelated issues. Kidney cysts can be attributable to heritable polycystic kidney diseases. These cysts are rare in children. In adults, they affect approximately 50% of individuals older than 50 years. Kidney cysts are categorized on imaging using the Bosniak Classification of Cystic Renal Masses, which determines the likelihood that cysts are malignant or benign. Asymptomatic Bosniak class I and II cysts require no further evaluation or follow-up; however, symptomatic large simple cysts might require treatment. Bosniak class III and IV cysts might be malignant and require excision. Kidney tumors also occur in children and adults. In children, the most common is Wilms tumor, but after age 10 years renal cell carcinoma (RCC) is more common. In adults, kidney tumors may be malignant or benign. RCC accounts for 85% of kidney tumors in adults, often with metastatic disease. In patients with kidney tumors, biopsy typically is avoided to prevent spread of malignant cells. Tumors that appear suspicious for cancer on imaging are managed directly, which can include total or partial nephrectomy, ablation therapy, and adjuvant therapies, along with chemotherapy and radiotherapy depending on tumor stage. For some patients, evaluation may involve consideration of genetic testing for hereditary cancer syndromes. Patients with these syndromes should undergo periodic screening for RCC.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"543 ","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal and Urinary Conditions: Glomerulonephritis. 肾脏和泌尿系统疾病：肾小球肾炎

FP essentials Pub Date : 2024-08-01

Madison L Paul

{"title":"Renal and Urinary Conditions: Glomerulonephritis.","authors":"Madison L Paul","doi":"","DOIUrl":"","url":null,"abstract":"Glomerulonephritis (GN) encompasses a heterogeneous group of disease processes. It accounts for approximately 20% of chronic kidney disease and is the second most common cause of kidney failure worldwide. A study of a cohort of Medicare patients found that approximately 1.2% were affected. GN should be suspected in patients with unexplained hematuria, particularly with persistent hematuria with red blood cell casts and/or acanthocytes, and proteinuria. Other presenting features include purpura (in children) and hypertension. When GN is suspected based on test results, patients should be referred to a nephrologist for further evaluation and consideration of kidney biopsy, which is the gold standard diagnostic test. GN is categorized as acute (sudden onset of hematuria and proteinuria) or chronic (with irreversible scarring on biopsy). Acute GN is more likely to be reversible. Initial management consists of supportive and protective measures, including blood pressure control, drugs to block the renin-angiotensin system, and lifestyle modifications to minimize cardiovascular risk. The underlying cause should be treated when possible. Subsequent management depends on the specific type of GN and might include antimicrobial therapy and/or immunosuppressive therapy when appropriate.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"543 ","pages":"7-11"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal and Urinary Conditions: Foreword. 肾脏和泌尿系统疾病：前言。

FP essentials Pub Date : 2024-08-01

Barry D Weiss

引用次数: 0

Renal and Urinary Conditions: Nephrotic Syndrome. 肾脏和泌尿系统疾病：肾病综合征。

FP essentials Pub Date : 2024-08-01

Alain Michael P Abellada

{"title":"Renal and Urinary Conditions: Nephrotic Syndrome.","authors":"Alain Michael P Abellada","doi":"","DOIUrl":"","url":null,"abstract":"Patients with nephrotic syndrome (NS) present with edema, proteinuria, hypoalbuminemia, and hyperlipidemia. In children, the most common causes are idiopathic minimal change disease and focal segmental glomerulosclerosis (FSGS). In adults, FSGS and membranous nephropathy (MN) are the most common primary causes. There are numerous secondary causes, including diabetes, amyloidosis, systemic lupus erythematosus, hematologic malignancies, and infections. In addition to confirming the diagnosis of NS by measuring proteinuria and serum albumin and lipid levels, evaluation should assess for secondary causes. In children, most cases are due to minimal change disease, which is responsive to steroid treatment. A glucocorticoid should be prescribed for children younger than 12 years. If the patient improves with steroid treatment, no biopsy is needed. If the patient does not improve, genetic testing and kidney biopsy are warranted to determine the diagnosis. In adults, biopsy typically is indicated for diagnosis, except in patients with positive test results for serum anti-phospholipase A2 receptor antibodies. This is diagnostic of MN. For patients with NS, management of initial and infrequent recurrences involves reduction of proteinuria with glucocorticoids. Frequent recurrences and/or the inability to discontinue glucocorticoids requires alternative therapies. Steroid-resistant NS also requires use of alternative therapies. Long-term NS management includes dietary sodium restriction, edema management, and blood pressure control. Thromboembolism prophylaxis should be considered for patients with NS and high risk of thromboembolism, particularly those with MN.","PeriodicalId":38325,"journal":{"name":"FP essentials","volume":"543 ","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0