In addition to general health and wellness, exercise is an essential element to blood glucose regulation in patients with diabetes mellitus. Studies have found the benefits of exercise include decreased body mass index (BMI), lower hemoglobin A1C levels, reduced diabetic ketoacidosis (DKA) rates and fewer comorbidities such as dyslipidemia, retinopathy and microalbuminuria. “Exercise is the…
The patient A female age 5 years and 11 months presented for evaluation of spinal deformity and back pain in September 2020 from a pediatrician referral. X-rays showed a 53-degree scoliosis curve in the thoracic spine and 42 degrees in the lumbar spine. An MRI was ordered to look for any other spino-neural axis abnormalities….
Norton Children’s Leatherman Spine, affiliated with the UofL School of Medicine, offers a scoliosis exercise program based on the methods first used by German scoliosis patient Katharina Schroth. The method’s namesake had moderate scoliosis herself, and after years of wearing uncomfortable steel braces, she began using breathing techniques, pulley systems and stretches to halt the worsening of her…
When a child who plays sports is limping, it’s often the result of a sprain or an overuse injury, but there are more serious injuries and conditions a clinician should consider. “In many cases there is at least some trauma, whether you just stubbed your toe or broke your ankle, so trauma — especially in…
Kendra S. Cloyd, M.D. Pediatrics Adam M. Skaff, M.D. Pediatric Cardiology Emily Buckmiller, PA-C Pediatric Emergency Medicine Drita Kamberi, APRN Maternal-Fetal Medicine
The patient The 12-year-old female presented with concern for spinal deformity. Initial curvature was 30-degree right thoracic curve and a 24-degree left lumbar curve. She was treated with a thoracic lumbar sacral orthosis (TLSO). Unfortunately, her curve progressed to over 45 degrees in the thoracic spine and 35 degrees in the lumbar spine. The challenge…
What is positive discipline? Parenting comes with a lot of responsibility, which includes teaching a child how to behave. The American Academy of Pediatrics (AAP) recommends that pediatricians teach families about positive discipline strategies that can show children how to manage their behavior while keeping them safe from harm. Positive discipline also can keep parents’…
Tumors in the central nervous system (CNS) account for 20% of childhood cancers, with 5.65 cases and 0.72 deaths per 100,000 children under 14 in the United States. Brain tumors are second only to acute lymphoblastic leukemia in incidence. While recent advances have resulted in greater life expectancy for some childhood CNS tumor patients, the…
Clinicians managing a child or adolescent with Type 1 diabetes often have very little accurate information about the patient’s physical activity, but a new study shows activity monitors like wearable fitness trackers provide a clear picture to help balance activity with nutrition or insulin needs. “Patients often overestimate their amount of physical activity. This study demonstrated…
Primary care providers play an invaluable role in the diagnosis of diabetes in children. The hallmark clinical symptoms of diabetes include polyuria and polydipsia. Nocturia and fatigue are also common. If the hyperglycemia has been long-standing, weight loss occurs at presentation. Glycosuria and ketonuria also may be present at the time of diagnosis. About a…
Over the past 20 years, the number of psychotropic medications children receive has increased dramatically, with large increases in attention-deficit/hyperactivity disorder (ADHD) medications and antipsychotics. Psychotropic medications can level the biologic playing field for children by treating established mental health disorders and controlling disabling symptoms such as hyperarousal and impulsivity. But they do not change…
The patient A 12-year-old boy born with double-inlet left ventricle (DILV), mitral stenosis, left-sided superior vena cava coronary sinus and pulmonary stenosis: The patient had been through surgical palliation as a baby, leaving him with Fontan circulation. The challenge Over the past decade we’ve learned that single-ventricle Fontan circulation has significant impacts on the heart…