GENERAL PROFILE OF PEDIATRICS HUANG Guo-ying, M.D. ( 黄国英教授 ) Professor, Department of Pediatrics Shanghai Medical College Fudan University gyhuang@shmu.edu.cn
Requirements in this lesson To be familiar with the characteristics of Pediatric medicine To master the features of development in children at various age stages (fetal, neonatal, infantile, toddler, preschool, school and adolescent) References McMillan JA. Oski s Pediatrics, the 4th ed. Philadelphia: Lippincott William & Wilkins, 2006
History of Fudan Children s Hospital Founded in 1952 Equipped with 100 beds Founder and first president Prof. CHEN Chui-zhen
History of Fudan Children s Hospital 1954~2008 with 300 beds
New Facilities of Fudan Children s Hospital
Completion Ceremony of the New Hospital in November 17, 2007
CONTENTS The field of pediatrics The features of development in children at various ages
Definition of Pediatrics Pediatrics is concerned with the physical, mental, and psychosocial health of infants, children and adolescents. It is about children s health and the factors that affect their health. It is about the education of pediatricians and about research. Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. WHO 1948
The Field of Pediatrics About the prevention and treatment of diseases from conception to maturity About growth and development, nutrition, and genetics About the health care of those individuals who will make the future of the world possible
Changes of Pediatric Practice The pediatric practice has been dramatically changed since 1910s Preventive services such as immunization, screening and counseling have become the cornerstone of pediatric practice in the developed countries and districts To diagnose and treat childhood diseases is still the priority of pediatric practice in most countries
Challenges to Pediatric Medicine Disparities of health care infectious diseases in most countries while chronic illness, disability, psychosocial and behavioral problems in the developed countries and districts The interplay between environmental influences and factors intrinsic to the child congenital and genetic disorders environmental factors that affect optimal outcome of child health
Goal of Pediatric Medicine To improve quality of health care, prevention & treatment of diseases To optimize children s physical, cognitive, and socio-emotional development To decrease morbidity and mortality
Modern Pediatrics Clinical Pediatrics Management of Diseases Preventive Pediatrics Prevention of Diseases Developmental Pediatrics Growth and Development And more Perinatology, Neonatology, Adolescent Medicine
Pediatric Medicine includes many sub-specialties Pediatric Gastroenterology Pediatric Pulmonology Pediatric Hematology and Oncology Pediatric Nephrology and Urology Pediatric Endocrinology Pediatric Dermatology Pediatric Cardiology and Cardiac Surgery Pediatric Neurology etc Primary child health care Infectious diseases Pediatric emergency and critical care, etc
CONTENTS The field of pediatrics The features of development in children at various ages
Age Stages from Conception to Maturity Embryonic and Fetal Stage Neonatal Stage Infantile Stage Toddler s Stage Preschool Stage School Stage Adolescent Stage
Embryonic and Fetal Stage Definition and development features Embryonic stage Within 8 or 12 weeks of gestation; the fertilized ovum differentiates rapidly into an organism that has most of the gross anatomic features of the human form. Fetal stage after 12 weeks of gestation; distinguished by rapid growth and elaboration of function.
Embryonic and Fetal Stage Main problems Vulnerable to a variety of factors including infection, distress, injury by radiation and chemicals, immunologic disorders, or maternal nutritional disturbances; leading to abortion, dead fetus, preterm, IUGR, congenital anomalies, etc..
Neonatal Stage Definition Period from birth to 28 days of age Development features survive independently, but the transition from intrauterine to extrauterine life requires activation of a number of functions which have been dormant, such as enzymatic, haemostatic, and immunologic, etc.. Main Problems hypothermia, infection, jaundice, inborn metabolic error, congenital anomalies
Infantile Stage Definition Period from birth to 12 months of age Development features rapid process of physical growth and physiological development during the life Establishment of emotional and social bonds with mother greater requirement of nutrition weak digestion and immunity functions Main Problems dyspepsia, malnutrition, infection
Toddler s Stage Definition Period from 1y to 3yrs of age Development features Slower rate of physical growth Rapid cognitive development such as highly imitative, increasingly responsive to others Main Problems communicable diseases, accident, poisoning
Preschool Stage Definition Period from 3yrs to 6 or 7yrs of age Development features Steady gain in weight and height of the body Development of social-emotional functions with curiosity, questioning, mimicking Main Problems accident, behavior problem, communicable diseases, anxieties such as fear of separation
School Stage Definition Period from 6yrs or 7yrs to adolescence, which usually starts from 10 in girls and 12 in boys Development features complete development of all organs and systems except for genital system New life environment: study, education at school Main Problems Behavior problems, caries of the teeth, myopia, sexual precocity
Adolescent Stage Definition girl: period from 10 to 17 or 18yrs boy: period from 12 to 18 or 20yrs
Adolescent Stage Development features Growth spurt Rapid development of genital system with sexual muturation Main Problems psychological, psychiatric, behavior, nutrition, accident, etc
Summary
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