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Manual of Pediatric Therapeutics. Thoroughly updated for its Seventh Edition, this practical quick-reference manual presents authoritative patient management . Manual of Pediatric. Therapeutics. 6th ed, by John W. Graef, MD, pp, with illus, $, Philadelphia, Pa,. Lippincott-Raven Publishers, This edition. Manual of Pediatric Therapeutics: Fifth edition. Author: Department of Medicine. Publication Year: Item available on request. Request this item. Contents.

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Clinical pharmacology is concerned with how systems of therapeutics interact with patients. Conservation medicine studies the relationship between human and animal health, and environmental conditions.

Also known as ecological medicine, environmental medicine , or medical geology. Disaster medicine deals with medical aspects of emergency preparedness, disaster mitigation and management.

Diving medicine or hyperbaric medicine is the prevention and treatment of diving-related problems.

The Washington Manual of Pediatrics ( Lippincott Manual Series )

Evolutionary medicine is a perspective on medicine derived through applying evolutionary theory. Forensic medicine deals with medical questions in legal context, such as determination of the time and cause of death, type of weapon used to inflict trauma, reconstruction of the facial features using remains of deceased skull thus aiding identification.

Gender-based medicine studies the biological and physiological differences between the human sexes and how that affects differences in disease. Hospice and Palliative Medicine is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal illnesses including cancer and heart failure. Hospital medicine is the general medical care of hospitalized patients.

Physicians whose primary professional focus is hospital medicine are called hospitalists in the United States and Canada. Laser medicine involves the use of lasers in the diagnostics or treatment of various conditions. Medical humanities includes the humanities literature , philosophy , ethics , history and religion , social science anthropology , cultural studies , psychology , sociology , and the arts literature , theater, film, and visual arts and their application to medical education and practice.

Health informatics is a relatively recent field that deal with the application of computers and information technology to medicine. Nosology is the classification of diseases for various purposes.

Occupational medicine is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained. Pain management also called pain medicine , or algiatry is the medical discipline concerned with the relief of pain.

Pharmacogenomics is a form of individualized medicine. Podiatric medicine is the study of, diagnosis, and medical treatment of disorders of the foot, ankle, lower limb, hip and lower back. Sexual medicine is concerned with diagnosing, assessing and treating all disorders related to sexuality.

Therapeutics is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health.

Tropical medicine deals with the prevention and treatment of tropical diseases. Regression Autism develops sometime during pregnancy and the first three years of life.

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Some parents report that their child seemed different at birth. These children are referred to as having early-onset autism. Other parents report that their child seemed to develop normally and then had a major regression resulting in autism, usually around months.

These children are referred to as having late-onset or regressive autism.

However, many parents report that their children were completely normal e. A study published in , conducted by the first author, compared 53 autistic children with 48 typical peers. The parents of the early-onset autism group reported a significant delay in reaching developmental milestones, including age of crawling 2 month delay , sitting up 2 month delay , walking month delay , and talking 11 month delay or more.


Thus, there appeared to be a delay in gross motor skills as well as of talking, so many children with autism also need physical therapy. In contrast, the late-onset autism group reached developmental milestones at the same time as typical children.

Several brain autopsy studies have been interpreted as suggesting that brain damage occurred sometime during the first trimester of pregnancy, but many of these studies involved individuals who were born prior to Thus, these findings may not apply to what appears to be the new population of people with regressive autism.

However, siblings can also be normal or even exceptional. The siblings of a child with autism are also at increased risk of speech impairments and cognitive disabilities, which sometimes go undetected.

There is no consensus on which environmental factors increase the risk of autism. A few of the suspected environmental causes for which there is some scientific evidence include: food allergies, pesticides, heavy metal toxicity, excessive use of oral antibiotics, deficiencies in essential nutrients, prenatal ultrasound, and many more.

Many children with autism have abnormalities in their immune system, and these abnormalities likely contribute to their symptoms. Those problems are treatable with folinic acid a special form of folic acid and vitamin B12, and may reduce the risk of having a child with autism. These problems are also very common in children with autism, and treatment with folinic acid and vitamin B12 has been shown to improve them.

We do not know why there has been a dramatic increase in autism over the past 25 years, but there are several reasonable hypotheses. Since there is more than one cause of autism, there may be more than one reason for the increase. Parents should request non-verbal intelligence tests that do not require language skills, such as the Test for Nonverbal Intelligence TONI. Regardless of the result, realize that autistic children will develop more skills as they grow older, and that appropriate therapies and education can help them reach their full potential.

These seizures can range from mild e. Most people with autism have subclinical seizures which are not easily noticeable but can significantly affect mental function. A recent large survey of treatment effectiveness Frye and Adams, found that standard anti-seizure medications do control seizures but often worsen other symptoms, some more so than others.

There is much evidence that certain nutritional supplements, especially vitamin B6 and dimethylglycine DMG , can provide a safer and more effective alternative to drugs, for many individuals. Note: Diarrhea may actually be due to constipation—i. Manual probing often fails to find an impaction. An abdominal x-ray is a simple method to check for hidden constipation, but needs careful interpretation. Children with significant gastrointestinal problems should see a pediatric gastroenterologist.

Unfortunately, gastrointestinal problems are often ignored and untreated due to autism, but it is important for parents to persevere and seek medical help.

Sleep Problems: Many with autism have sleep problems. Night waking may be due to reflux of stomach acid into the esophagus, often caused by food intolerances.

Additional resources.

Placing bricks under the mattress at the head of the bed may help keep stomach acid from rising and provide better sleep; possible dietary issues should be discussed with a knowledgeable professional. Many rigorous studies have shown that melatonin is often useful in helping autistic individuals fall asleep. Other popular interventions include tryptophan or 5-HTP nutrients which the body converts to melatonin.

Implementing a regular bedtime routine taking a bath, brushing teeth, reading a book can help induce sleep. Vigorous exercise will help a child sleep, and other sleep aids include a weighted blanket or tight fitting mummy-type sleeping bag. Pica refers to eating non-food items such as paint, sand, dirt, paper, etc. Pica can expose the child to heavy metal poisoning, especially if there is lead in the paint or in the soil.

Discuss zinc supplementation with your clinician. That study found that these children tend to have low potassium levels. Increased consumption of fruit and vegetables good sources of potassium may be helpful. Occupational and physical therapy, implemented on a daily basis, can help.

Sensory Sensitivities: Many autistic children have unusual sensitivities to sounds, sights, touch, taste, and smells. High-pitched intermittent sounds, such as fire alarms or school bells, may be painful to autistic children. Scratchy fabrics may also be intolerable, and some children have visual sensitivities. They are troubled by the flickering of fluorescent lights.

Sensory sensitivities are highly variable in autism, from mild to severe. Even though a pure tone hearing test may imply normal hearing, the child may have difficulty hearing auditory details and hard consonant sounds. Some children have very high pain thresholds i. Interventions designed to help normalize their senses, such as sensory integration, Auditory Integration Training AIT , and Irlen lenses, are discussed later in this paper.

Unfortunately, many physicians believe, though incorrectly, that the only useful medical treatments are psychiatric medications to reduce seizures and behavioral problems.

Genetic testing for Fragile X syndrome can help identify one possible cause, and this testing is typically recommended when there is mental retardation in the family history. The Autism Research Institute supports an integrative medical approach to treating individuals on the autism spectrum. This approaches often includes: Thorough medical evaluation for undetected underlying disease Nutritional support Testing for hidden food allergies, and avoidance of allergenic foods Treatment of medically diagnosed, intestinal bacterial infections back to menu Psychiatric Medications The various topics covered in this overview paper for parents of young autistic children represent, for the most part, a consensus of the views, based on research and personal experience, of all four authors.

However, the authors differ in their opinions on the role psychoactive drugs should play.Very few individuals recover completely from autism without any intervention.

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Since there is more than one cause of autism, there may be more than one reason for the increase. Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education.

One must balance risk versus benefit. Sexual medicine is concerned with diagnosing, assessing and treating all disorders related to sexuality.

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