2015-11-18

Department of and Developmental Disorders Medical University of Bialystok Head of the Dept.: Assoc. Prof. Jerzy Konstantynowicz, MD, PhD

Introduction to Pediatrics

General issues in child health & care

Assoc. Prof. Jerzy Konstantynowicz, MD, PhD

Pediatrics

Developmental Pediatrics & school medicine

Pediatrics & adolescent medicine

Neonatology (newborn: 0 – 28 days of life)

Auxology (?)

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Pediatrics slightly differs from ‘adult’ medicine

 Age range: 0 – 18 years

 Parental assistance during each visit, check-up or hospital stay

 The goal of modern pediatrcs is mainly preventive medicine, not just repair or intervention

Diseases in infancy & childhood (symptoms, clinical manifestations, aetiology) depend on age / developmental stage

Auxology = of growth

 is a meta-term covering the study of all aspects of physical growth (Paul Godin 1903)

 is a highly multi-disciplinary science involving health / medicine, (pediatrics, general practice, , neuroendocrinology, physiology, ) and, to a lesser extent: , , , ergonomics, socioeconomics, , and among others.

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KNOWLEDGE OF NORMAL GROWTH AND DEVELOPMENT employed in

 Prevention  Diagnostics  Prognostics  Rehabilitation

Health maintenance, developmental surveillance and prophylactic activities… Preventive strategies in pediatrics

Health status in adulthood

INTERNAL MED. PEDIATRICS CARDIOLOGY ENDOCRINOLOGY GENETICS RHEUMATOLOGY DIABETES CARE ORTHOPEDICS REHABILITATION GYNAECOLOGY GASTROENTEROLOGY GERIATRICS

F A M I L Y M E D I C I N E

18 years Age

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Comparison of health care proportions, services, reasearch and published studies between developmental medicine (pediatric care) and adult medicine

Pediatrics Adult medicine

16 – 20 yrs Adolescent medicine

18 years Age

C o n t i n u u m

18 yrs is only Age a formal cut-off point

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All chronic diseases (inborn or acquired) in childhood are transferred to adulthood

or

… (at least) may be associated with late consequences in distant future i.e. in later life

GENERAL CATEGORIES essential to pediatric care

Growth increase of the size of the body (quantitative) strongly associated with the genetic potential

Differentation morphological / structural changes of tisues, organs and systems shaping typical age-related body proportions

Maturation functional perfection of organs and systems, inter-organ integration of the whole body

Anthropometric measurements (weight, length / standing height, BMI, head & chest circumferences) are essential for pediatric care and monitoring growth.

This is mandatory procedure!

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standard reference ranges, however…

Individual variations exist ! Individual trajectory

First issue is child’s age:

Chronological (calendar) age

years & months (be precise!)

First issue is child’s age:

If there is a discrepancy between calendar age and somatic features…

Check biological characteristics: - Bone age (X-ray of the hand / wrist) - Sexual maturation (Tanner stage) - Dental age - Morphological age

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Main causes of mortality in children

1 – 4 y 5 – 9 y

 Injury / Accident  Injury / Accident  Congenital defects  Cancer  Cancer / Tumors /  Congenital defects ALL  Homicide / Suicide  Cardiac defects  Cardiac defects

Main causes of mortality in children

10 – 14 y 15 – 24 y

 Injury / Accident  Injury / Accident  Cancer / Tumors  Suicide  Suicide  Homicide  Homicide  Cancer  Congenital defects  Cardiac defects

What does receive a well-being child ?

What is mangement of a healthy person during growth ?

Provide care, security and positive emotions Good environment & external temperature & sanitary needs Nutrition (optimal: breast feeding until 6 mo) Complete immunization scheduled for infancy Vitamin K (if breastfed) Vitamin D (rickets prevention)

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Medical record /

Information obtained Skills & experience from patient of the staff

Initial diagnosis

Diagnostics Prognostic value

Observation / Monitoring

Therapy

90% of spot on Dx are possible due to 70% of accurate Pathology an appropriate diagnoses are based history and only on the history physical Physical examination examination

History

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