Health and Fitness

Impetigo

admin — Tue, 06 Jan 2009 00:13:21 +0000

A superficial skin infection, most commonly found in childhood, that is caused by streptococcal or staphlococcal bacteria. Impetigo should be treated as soon as possible to avoid spreading the infection to other children and to prevent a rare complication—a form of kidney disease called acute glomerulonephritis.

Cause
Impetigo is spread by touching and usually is found on exposed body areas such as the legs, face, and arms. Because impetigo is spread quickly through play groups and day care, children with the infection should be kept away from playmates and out of school until the sores disappear.

Symptoms
The condition starts as tiny, almost imperceptible blisters on a child’s skin, usually at the site of a skin abrasion, scratch, or insect bite. Most lesions occur on exposed areas, such as the face, scalp, and extremities. The red and itchy sores blister briefly, then begin to ooze for the next few days, leaving a sticky crust. Untreated, the infection will last from two to three weeks. Impetigo is most common during hot, humid weather.

Treatment
Children with impetigo need immediate medical care to avoid spreading the infection to others. Medication includes dicloxacillin, cephalosporin, or erythromycin for 10 days, together with topical application of mupirocin ointment.

Complications
Rarely, impetigo can lead to possible kidney disease known as acute glomerulonephritis.

Prevention
Cleanliness and prompt attention to skin injuries can help prevent impetigo. Children with the condition and their families should bathe regularly with antibacterial soaps and apply topical antibiotics to insect bites, cuts, abrasions, and infected lesions immediately. Impetigo in infants is especially contagious and serious. To prevent spreading, pillowcases, towels, and washcloths should not be shared and should be boiled after each use.

Imaginary Friends

admin — Mon, 05 Jan 2009 23:44:34 +0000

Imaginary playmates are a perfectly normal part of childhood that can offer youngsters a feeling of control in their lives. These invisible friends are not an indication of a mental health problem but are a common fact of life in many well-adjusted, creative children. Many children develop imaginary playmates between the ages of three and five, when they begin to form their own identities and to test the boundaries between fantasy and reality.

Imaginary friends enable children to try out different roles and allow children to explore issues of control and power without worrying about interactions with real authority figures. An imaginary friend can help a child work out difficult emotions and handle anxieties associated with major changes in the child’s life. Parents can monitor their child’s relationship with an imaginary friend to gain insights into how the child is coping.

While it is perfectly acceptable for parents to support the child’s belief, they should not get too involved in the playacting so that the children feel they have lost control of the game. Parents should not belittle the relationship nor let the imaginary playmate take the blame for the child’s mistakes. Children who see their parents taking the imaginary friend too seriously may worry that the adults don’t know what is real and what is make believe.

An imaginary friend should become of concern only when the child avoids meaningful interaction with other children in favor of playing exclusively with an invented friend. Most children abandon their imaginary friends once kindergarten begins. A child who continues to focus intently on an imaginary playmate beyond that time may benefit from a professional consultation to explore any hidden worries.

Ichthyosis

admin — Mon, 05 Jan 2009 23:39:02 +0000

A family of at least 20 rare skin disorders characterized by dry, thickened rough, scaling, darkened skin triggered by too much keratin (the main protein component of skin). This group of genetic diseases ranges from mild generalized dry skin (ichthyosis vulgaris) to severe widespread thickened scaly dry skin (lamellar ichthyosis). The disorder’s name is derived from the Greek word ichthus meaning “fish” because the appearance and condition of the skin resemble fish scales. It affects more than one million Americans.

Symptoms
Ichthyosis vulgaris, which affects the thighs, arms, and backs of the hands, usually appears at or shortly after birth and improves as the child grows up. However, in severe conditions, the infant may be stillborn, encased in skin as hard as armor plate. It is not contagious and is not caused by germs.

Treatment
There is no cure for any of the ichthyoses, which are lifelong diseases, but lubricants and ointments may help the skin dryness, and bath oils can moisten the skin. Ichthyosis improves in a warm, humid climate and worsens in cold weather. Washing with soap aggravates the condition.

Hypoglycemia

admin — Mon, 05 Jan 2009 23:09:49 +0000

A condition of low levels of sugar in the blood that causes muscle weakness, uncoordination, mental confusion, and sweating. Hypoglycemia is a very serious condition that must be treated immediately. If untreated, it can progress to a coma. Hypoglycemia can occur in any infant or child who takes insulin injections for diabetes, or in people with type 2 diabetes taking certain medications. Almost every child who takes insulin will have low blood sugar at one time or another.

Cause
When blood sugars drop too low, the brain cannot get the glucose it needs to function properly. The level at which low blood sugar gets serious depends on the child’s age, health, and whether or not the child has had hypoglycemia before.

Symptoms
The symptoms of low blood sugar range from mild to severe. Mild symptoms include hunger, sweating, headache, rapid heartbeat, and pallor. Moderate signs include irritability, poor coordination, lethargy, and confusion. Severe signs include losing consciousness or having seizures.

While severe symptoms are easy to spot, mild to moderate low blood sugar is not always easy to recognize. Some of the same symptoms might simply indicate a tired or sick child. The only way to tell for sure is to check the blood sugar levels. If for some reason a test is not possible, it is safer to assume that the cause of the child’s behavior is low blood sugar and treat the suspected low with carbohydrates. It is safer to treat a child for low blood sugar when levels are normal, than to ignore a situation in which the blood sugar is actually low.

Symptoms that a child may have low blood sugar at night include nightmares or bad dreams, stomachache or headache in the morning, ketones in the urine, and/or high or low blood glucose levels when the child wakes up. If these symptoms appear, blood sugar should be checked around midnight and again at 3 A.M. If a child is having lows during the night, the nighttime insulin dosage, type, or timing of the insulin injections may need to be adjusted. A meeting with the child’s diabetes treatment team is necessary.

The more lows a child has, the greater the risk for lows that go unrecognized in the future, because fewer warning signs actually appear. This is called “hypoglycemia unawareness.” On the other hand, symptoms of hypoglycemia can increase if the number of lows is decreased. A child who is having too many episodes of low blood sugar on a regular basis (such as every day) needs to have an adjustment in the diabetes regimen.

Treatment
To treat low blood sugar during the day, the child should immediately take 15 grams of glucose or a sugar source such as three or four glucose tablets, four ounces (half a cup) of 100-percent fruit juice, four ounces (half a cup) of regular (not diet) soda, or one tablespoon of sugar or honey.

If the symptoms do not go away in 10 to 15 minutes, the blood sugar test should be repeated. If the reading is still less than 70 mg/dl, the child should repeat the sugar treatment.

To treat low blood sugars at night, if blood sugar is below 70 mg/dl to 100 mg/dl at bedtime, the child should have one-and-a-half snacks. The blood sugar reading needs to rise to 120 mg/dl before the child goes to bed. The child’s blood sugar should be rechecked during the night, at about 3 A.M.

In the case of severe low blood sugar reading, the child should be given glucagon as prescribed. Although glucagon is rarely needed, it is vital to keep it on hand and to know how to use it if the blood sugar drops so low that the child cannot eat or drink. Glucagon is a very serious intervention. Signs that it is needed include lethargy, unconsciousness, or the inability to swallow normally. A glucagon kit usually contains a syringe with liquid, and a bottle with glucagon powder.

Prevention
It is possible to prevent hypoglycemia. Children should not skip meals or snacks, but if a child does not eat appropriately or eats less than usual during the day, blood glucose should be checked more often than usual during the rest of the day. If the blood glucose reading is too low (usually around 70 mg/dl), treatment should be given. A middle-of-the-night blood glucose reading should be done if a child has eaten less than usual during the day.

While exercise is important, extra physical activity can cause blood glucose levels to drop lower than usual, either during the exercises or much later (particularly during the night). When a child exercises more than usual, more carbohydrates (such as peanut butter and crackers) should be given.

To help prevent nighttime lows, a child’s blood sugar should be checked at bedtime and then followed with a snack. If the reading is below 100 mg/dl, it should be checked again in the middle of the night.

It is also important that everyone who cares for a child with diabetes (even school bus drivers) should know that the child has diabetes and takes insulin. They must also understand what hypoglycemia is, how to lessen the risk, and how to recognize and treat the problem. It is important to emphasize at school that a child who might be having a hypoglycemic episode should not be sent to the nurse’s office alone, even for a blood sugar check. A responsible person carrying a sugar source should accompany the child. Teachers should also understand that low blood sugar can be triggered by an altered mealtime, a skipped meal or snack, or extra physical activity. Low blood sugar can also occur at any time without an obvious reason.

Hyperactivity

admin — Mon, 05 Jan 2009 23:01:28 +0000

Constant and excessive movement and activity. A child with hyperactivity may not be able to stop an action when directed to, or to sit still for any period of time. Hyperactivity often occurs with inattentiveness and impulsivity. An affected child might have trouble sitting still, fidget excessively, and move about excessively even during sleep. Onset occurs before age seven. Behaviors are chronic (present throughout the child’s life), present throughout the child’s day, and are not due to other factors such as anxiety or depression.

In older children, symptoms of hyperactivity may be more subtle, displaying themselves in restlessness, fidgeting, a tendency to interrupt in class, or in conflict-seeking behaviors with peers and family members.

Hydrocephalus

admin — Sat, 03 Jan 2009 01:25:43 +0000

An excess of cerebrospinal fluid within the skull, also known as “water on the brain.” This condition is often present at birth in association with other abnormalities, especially SPINA BIFIDA. Untreated, the condition will progress to extreme sleepiness, seizures, and severe brain damage, and it may be fatal in a few weeks.

Cause
Hydrocephalus is caused by the excessive formation of spinal fluid, by a blockage of this fluid, or both. It may be present at birth or develop after a severe head injury, brain hemorrhage, infection (such as MENINGITIS), or brain tumor.

Symptoms
If the condition is present at birth, the symptoms include an enlarged head that continues to grow at an excessively fast rate, because the baby’s skull bones are not rigid, and they expand to accommodate the fluid. Other symptoms may include leg rigidity, EPILEPSY, irritability, lethargy, vomiting, and absence of reflexes.

If the condition occurs later in childhood, the skull cannot swell and the symptoms will be caused by a rising pressure within the skull characterized by HEADACHE, vomiting, loss of coordination, and deteriorating mental function.

Diagnosis
The condition is diagnosed with computerized axial tomography (CAT) or magnetic resonance imaging (MRI) brain scans, which can reveal the location and nature of the problem.

Treatment
Excess fluid can usually be drained away by using a shunt from the brain to another part of the body (such as the lining of the abdomen), where it can be absorbed by the body. The shunt is inserted into the brain through a hole in the skull; sometimes, the device will be left in place indefinitely.

In older children, treatment may be aimed at resolving the underlying condition (head injury, brain hemorrhage, infection, or tumor).

Humidifiers

admin — Sat, 03 Jan 2009 01:19:38 +0000

The use of a humidifier in a child’s bedroom during the winter can help keep mucous membranes moist and healthy—but poorly maintained humidifiers can be the source of infection.

The nose, throat, and lungs work best when the air has a relative humidity of about 40 percent. If the air during the winter falls below that level, moisture will be absorbed into the heated air from the mucous membranes. Since dried mucous membranes cannot clean themselves, they become more vulnerable to invasion from cold viruses. A well-maintained humidifier can keep the air humid and nose and throat moist.

However, it is important that the device be used correctly. If the air becomes too humid, or the machine is not properly cleaned, mold and dust mites can multiply. To keep the risk of infection from molds or bacteria to a minimum, the humidity should not be allowed to rise above 40 percent. In addition, the water reservoir in the humidifier should be cleaned daily with a vinegar solution.

Hookworm

admin — Sat, 03 Jan 2009 01:08:50 +0000

A small, round, bloodsucking worm that penetrates the skin, causing a red, itchy rash on the feet. In the United States, children can become infested when the common hookworm is passed through a dog’s feces and is deposited into the soil.

Once inside the body, hookworms travel to the lungs and then inside the small intestine, where they attach themselves and drain blood for nourishment. Heavy hookworm infestation can cause considerable damage to the intestinal wall. While one hookworm extracts only a fraction of a teaspoon of blood from the circulation every day, more severe infestations can be more serious. Since children cannot replace lost blood quickly, this may cause an iron deficiency and malnutrition. Chronic infestation with worms can lead to slowed growth and impaired behavioral, cognitive, and motor development. Occasionally hookworm infestation can be fatal (especially in infants). Since transmission of hookworm infection requires development of the larvae in soil, hookworm cannot be spread person to person.

Symptoms
There may be no symptoms in a minor infestation; in more severe cases, the worms can cause abdominal pain, anemia, cough, diarrhea, mental slowness, and pneumonia, in addition to an itchy rash.

Treatment
In the United States, hookworm infections are generally treated for one to three days with medication such as mebendazole to kill the worms. The drugs are effective and appear to have few side effects. For children under the age of two, the decision to treat should be made by a pediatrician.

Another stool exam should be repeated one to two weeks after therapy. If the infection is still present, treatment will be given again. Iron supplements will be ordered if the patient has anemia.

Prevention
The best prevention is to improve sanitation so that transmission cannot occur, which is how hookworm infestations were eradicated from the southeastern United States. Children should not walk barefoot or contact the soil with bare hands in areas where hookworm is common, or where there is likely to be feces in the soil or sand.

Hives

admin — Thu, 01 Jan 2009 22:44:04 +0000

Raised, red blotchy welts of various sizes that can appear and disappear randomly on the surface of the skin. This reaction is known medically as urticaria (from the Latin word urtica for “nettle”).

About one in five children experiences hives at some point in their lives, which are physically uncomfortable but generally harmless. Eventually, hives will disappear on their own without leaving any marks or scars.

Cause
While the cause of the reaction is often unknown, hives appear when a child is exposed to a trigger, prompting certain cells in the body to release histamine, a chemical released during allergic reactions. Hives appear when histamine causes blood plasma to leak from the small blood vessels under the skin.

A wide variety of triggers have been known to cause hives, including food, pollen, animal dander, drugs, insect bites, infections, illness, cold, heat, light, or stress. Foods that have been linked with hives include shellfish, fish, berries, nuts, eggs, and milk. Penicillin and aspirin are two types of drugs that may also trigger hives in susceptible patients.

In rare cases, hives can swell significantly and affect deeper layers of the skin and other parts of the body. This condition is called angioedema. In some children, there may be a genetic component to the angioedema. Termed “hereditary angioedema,” this condition is characterized by nonitchy swellings lasting three or four days that may be triggered by trauma or may appear spontaneously. With angioedema, the hands, feet, eyelids, lips, and even breathing passages can swell. Treatment for these is the same as for common hives.

Diagnosis
The pediatrician may be able to determine the cause of hives with a detailed medical history, including a detailed diary of exposure to foods, chemicals, new products, and possible irritants over a period of two weeks to a month before onset. However, because hives may be triggered by such a wide variety of irritants, it may never be possible to find out the exact cause.

Treatment
In many cases, hives will disappear or fade away on their own without any treatment. More persistent cases will respond to antihistamines, but other drugs also may be prescribed by the pediatrician, including adrenaline or epinephrine, terbutaline, oral corticosteroids, or cimetidine.

Histoplasmosis

admin — Thu, 01 Jan 2009 22:24:53 +0000

An uncommon infection caused by inhaling fungus spores that infect the lungs. Spontaneous recovery is typical, although small calcifications remain in the lungs and affected lymph glands. While anyone can get histoplasmosis, it is found most often among those with an impaired immune system, such as AIDS patients.

Infection confers immunity. The disease is most common in the Mississippi and Ohio River Valleys.

Cause
Histoplasmosis is caused by the organism Histoplasma capsulatum, which is a single budding yeast at body temperature, and a mold at room temperature. The fungus is spread by airborne spores from soil contaminated with bird droppings and is commonly found in the Mississippi River Valley.

The fungal infection enters the body when a child breathes in spores of the fungus from dried bird droppings. In addition to the lungs, the fungus may occasionally invade other parts of the body. Birds (especially chickens), bats, dogs, cats, rats, skunks, opossums, foxes, and other animals also can get the disease and may play a role in spreading it. Outbreaks may occur in groups with common exposure to bird or bat droppings, or recently disturbed soil in chicken coops, caves, or elsewhere. Person to-person spread of the disease does not occur. Past infection with histoplasmosis usually reduces chances of getting the disease again, but permanent immunity does not occur.

Symptoms
Most infected children do not have any symptoms. Those who do will experience mild to severe fever, malaise, cough, and swollen lymph nodes between five and 18 days after exposure. Progressive histoplasmosis is a sometimes-fatal generalized form of the disease, characterized by ulcers in the mouth and nose, enlarged spleen, liver, and lymph nodes, and serious lung infection.

Diagnosis
Examination and blood test will confirm the disease.

Treatment
Progressive histoplasmosis is treated with amphotericin B; less severe cases may be treated with ketoconazole.