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Biomedical subjects

Donna M Roberts

Publications and source records attributed to Donna M Roberts.

3 recordsLinked to original sources

Community-acquired pneumonia in infants and children.

Community-acquired pneumonia is one of the most common serious infections in children, with an annual incidence of 34 to 40 cases per 1,000 children in Europe and North America. When diagnosing community-acquired pneumonia, physicians should rely mainly on the patient's history and physical examination, supplemented by judicious use of chest radiographs and laboratory tests as needed. The child's age is important in making the diagnosis. Pneumonia in neonates younger than three weeks of age most often is caused by an infection obtained from the mother at birth. Streptococcus pneumoniae and viruses are the most common causes in infants three weeks to three months of age. Viruses are the most frequent cause of pneumonia in preschool-aged children; Streptococcus pneumoniae is the most common bacterial pathogen. Mycoplasma pneumoniae and Chlamydia pneumoniae often are the etiologic agents in children older than five years and in adolescents. In very young children who appear toxic, hospitalization and intravenous antibiotics are needed. The symptoms in outpatients who present with community-acquired pneumonia can help determine the treatment. Knowing the age-specific causes of bacterial pneumonia will help guide antibiotic therapy. Childhood immunization has helped decrease the incidence of invasive Haemophilus influenzae type B infection, and the newly introduced heptavalent pneumococcal vaccine may do the same for Streptococcus pneumoniae infections.

Age Factors↗

Infantile colic.

Infantile colic can be distressing to parents whose infant is inconsolable during crying episodes. Colic is often defined by the "rule of three": crying for more than three hours per day, for more than three days per week, and for longer than three weeks in an infant who is well-fed and otherwise healthy. The physician's role is to ensure that there is no organic cause for the crying, offer balanced advice on treatments, and provide support to the family. Colic is a diagnosis of exclusion that is made after performing a careful history and physical examination to rule out less common organic causes. Treatment is limited. Feeding changes usually are not advised. Medications available in the United States have not been proved effective in the treatment of colic, and most behavior interventions have not been proved to be more effective than placebo. Families may turn to untested resources for help, and the physician should offer sound advice about these treatments. Above all, parents need reassurance that their baby is healthy and that colic is self-limited with no long-term adverse effects. Physicians should watch for signs of continuing distress in the child and family, particularly in families whose resources are strained already.

Colic↗