- Hydronephrosis in infants
Essential Evidence Topics, 10-Mar-2021
Overall Bottom Line: Causes of antenatal hydronephrosis range from transient physiologic changes to severe underlying pathology; therefore, a thorough evaluation is warranted. Perform postnatal ultrasounds during the first week and first month of life i - Hypospadias
Essential Evidence Topics, 7-Feb-2019
Overall Bottom Line: Circumcision is traditionally deferred upon discovery of hypospadias. Surgical repair is the only treatment. This is recommended between 6 and 18 months of life. Complication rates are higher for repair of proximal hypospadias co - Intellectual disabilities (adult)
Essential Evidence Topics, 31-Dec-2021
Overall Bottom Line: In caring for adults with intellectual disability (ID), assess their capacity for decision making using a tool adapted to the patient, consider their need for accommodations and supports, and identify with them a support person who ca - Intrauterine growth restriction
Essential Evidence Topics, 23-Nov-2021
Overall Bottom Line: Monitor all pregnancies for fetal growth. The USPSTF recommends low dose aspirin for women at risk for pre-eclampsia reduced the likelihood of intrauterine growth restriction (RR 0.82, 95% CI 0.68-0.99). Evaluate pregnancies compli - Kawasaki disease
Essential Evidence Topics, 23-Nov-2021
Overall Bottom Line: No gold standard test exists for diagnosis of Kawasaki disease (KD). Diagnosis must be made based on clinical features and, if there is atypical presentation, include supportive laboratory work and echocardiogram. Treatment for the - Lead poisoning
Essential Evidence Topics, 1-Oct-2021
Overall Bottom Line: Take a thorough environmental history to assess risk. Pay special attention to the condition of current housing and to occupational exposures. Follow state and local regulations (which vary) regarding screening in children. Venous b - Meningitis (child)
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: The initial treatment and management of meningitis in infants and children depends on early suspicion and recognition, rapid evaluation and diagnostic testing, and emergent antimicrobial therapy. Several validated risk scores such a - Necrotizing enterocolitis
Essential Evidence Topics, 8-Aug-2022
Overall Bottom Line: Suspect necrotizing enterocolitis (NEC) in infants with significant clinical deterioration in conjunction with signs of abdominal distension, bilious emesis, and bloody stool. Initial evaluation should include CBC, blood gas, blood - Neonatal abstinence syndrome
Essential Evidence Topics, 24-Nov-2021
Overall Bottom Line: Almost all infants exposed to prolonged in utero opioids will demonstrate some symptoms of withdrawal, with ~50% having signs and symptoms severe enough to require pharmacologic treatment. The use of a standardized symptom assessmen - Neonatal jaundice
Essential Evidence Topics, 29-Jul-2022
Overall Bottom Line: Neonatal jaundice occurs in a majority of infants and is generally benign. All infants should be evaluated to identify those at risk of developing severe hyperbilirubinemia and neurotoxicity from hyperbilirubinemia: acute bilirubin - Neural tube defects
Essential Evidence Topics, 27-Jan-2021
Overall Bottom Line: Low-risk women should take 400 μg of folic acid daily for at least 1 month prior to conception to reduce the rate of neural tube defects (NTDs) by 70%; high-risk women should take 4 mg of folic acid daily for at least 1 month prior to - Neuroblastoma
Essential Evidence Topics, 15-Oct-2021
Overall Bottom Line: No routine screening is recommended for neuroblastoma. Suspect neuroblastoma in children with abdominal mass or bone pain. Urine catecholamine metabolites, vanillylmandelic acid (VMA) and homovanillic acid (HVA), are useful for ev - Newborn evaluation
Essential Evidence Topics, 28-Feb-2022
OVERALL BOTTOM LINES: Maternal conditions significantly influence fetal health (see ). Apgar scores assess newborn requirement for resuscitation (see ); the score does not predict anoxic damage or cerebral palsy. Premature (<37 weeks) or low-birth- - Pneumonia (pediatric)
Essential Evidence Topics, 23-Jul-2022
Overall Bottom Line: Pneumonia is suggested in children with fever, tachypnea, hypoxia, retractions, and nasal flaring, but no single sign or symptom can determine if a child has pneumonia. Children with suspected bacterial pneumonia should be treated w - Pyloric stenosis
Essential Evidence Topics, 30-Mar-2021
Overall Bottom Line: Infants who are exposed to macrolides, especially in the first 2 weeks of life, are at increased risk for pyloric stenosis (PS). Palpation of the olive has a positive predictive value of 99.3%. Ultrasound findings of pyloric muscl - Respiratory distress syndrome (neonatal)
Essential Evidence Topics, 8-Nov-2020
Overall Bottom Line: Give one course of antenatal corticosteroids to mothers at risk of preterm delivery (before 35 weeks' gestation) to reduce the risk of respiratory distress syndrome (RDS) and death in their infants. Delay elective repeat cesarian se - Retinopathy of prematurity
Essential Evidence Topics, 5-Apr-2021
Overall Bottom Line: Retinopathy of prematurity (ROP) is a vascular retinopathy that develops only in premature infants with outcomes anywhere from normal vision to blindness. Incidence decreases with increasing birth weight and gestational age. Infants w - Reye's syndrome
Essential Evidence Topics, 29-Nov-2021
Overall Bottom Line: Reye's syndrome is now an uncommon diagnosis; disorders that can present with similar clinical features (such as disorders of fatty acid oxidation or urea cycle defects) are now far more common. Transfer to a pediatric intensive car - Roseola
Essential Evidence Topics, 7-Jan-2022
Overall Bottom Line: Acute febrile childhood illness with characteristic three- to four-day prodrome of high fever followed by defervescence and the appearance of a discrete, pink, morbilliform rash that often starts centrally (chest/trunk) and spreads to - Rotavirus
Essential Evidence Topics, 7-Jul-2022
Overall Bottom Line: Children should be vaccinated according to ACIP guidelines within the first year of life, which decreases hospitalizations and mortality from diarrheal illness. Suspect rotavirus in young children presenting with diarrhea, fever, an
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