History of paediatrics - Child-specific medical problems mentioned in the Hippocratic Corpus and the Sacred Disease - Greek philosophers and physicians discussed specific illnesses affecting children - Traces of paediatrics found in Ancient India - Ayurvedic texts like Sushruta Samhita and Kashyapa Samhita contain information about paediatrics - Byzantine physicians and Islamic Golden Age writers contributed to the field - Term 'paediatrics' introduced in English by Abraham Jacobi in 1859 - Jacobi is considered the father of American paediatrics - The first paediatric hospital, Hôpital des Enfants Malades, opened in Paris in 1802 - Similar institutions established in Berlin, Saint Petersburg, Vienna, Breslau, and London - First paediatric hospitals in Scotland and the US - Autonomy is traceable to ethical theory and law - Hippocrates highlighted the importance of patient autonomy in healthcare - Ancient societies did not prioritize paediatric medicine or children's rights - In the twentieth century, emphasis on children's rights increased - Best Interest Standard of Child developed to prioritize children's rights and best interests - The history of paediatrics dates back to ancient times, with early physicians recognizing the importance of specialised care for children - Soranus of Ephesus, a physician in Roman times, is considered one of the fathers of paediatrics - paediatric care has evolved over centuries, influenced by cultural, social, and medical advancements - The establishment of paediatric hospitals and the development of paediatric organizations have played a significant role in the advancement of paediatric medicine - The field of paediatrics continues to evolve and improve, with ongoing research and advancements in medical technology - Nestlé Nutrition Workshop Series, Vol. 22, provides a comprehensive history of paediatrics during the period of 1850-1950 - There is an official history site (in French) that focuses on nineteenth-century paediatric hospitals in Paris - The Mason Brown Lecture in August 1999 discussed the role of Scots in paediatric surgery during this time - 'paediatrics in the United States' by Howard A. Pearson, published in 1991, explores the development of paediatrics in the United States during this period - Commentaries by Edwards A. Park in the journal paediatrics shed light on important aspects of paediatric practice

Differences between adult and paediatric medicine - Physiological differences between infants/children and adults - Congenital defects, genetic variance, and developmental issues are of greater concern in paediatrics - Children are not simply little adults - paediatric physiology affects drug pharmacokinetics - Continual research needed to understand medication decisions in paediatrics

Medical Care - paediatrics involves medical care of infants, children, adolescents, and young adults - Age limits for paediatrics vary worldwide and have been trending upward - paediatricians work in various settings including clinics, research centers, and hospitals - Some paediatric subspecialists continue to care for adults up to the age of 25 - paediatricians specialize in different areas like neonatology

Pharmacokinetics - Neonates and young infants have increased stomach pH, affecting drug absorption - Acid is essential for degrading certain oral drugs, so absorption is greater in children due to decreased breakdown - Children have an extended rate of gastric emptying, slowing drug absorption - Drug absorption affected by factors like gastric pH and gastric emptying rate - Percentage of total body water and extracellular fluid volume decrease as children grow - paediatric patients have larger volume of distribution than adults - Dosing of hydrophilic drugs like ampicillin needs to be adjusted in children - Infants and neonates have fewer plasma proteins - Highly protein-bound drugs have fewer opportunities for protein binding in infants and neonates - Drug metabolism occurs via enzymes in the liver - Phase I and Phase II enzymes have different rates of maturation - Enzyme capacity, clearance, and half-life contribute to metabolism differences between children and adults - Drug metabolism can differ within the paediatric population - Neonates and infants have slower kidney maturation, affecting drug metabolism - Drug elimination facilitated via liver and kidneys - Infants and young children have increased renal clearance - Preterm neonates and infants have slower kidney maturation - Diseases affecting kidney function impact drug elimination - Lower doses and greater dosing intervals may be necessary for certain populations

Education and Training - Aspiring medical students need 4 years of undergraduate courses at a college or university - After college, future paediatricians must attend 4 years of medical school and later do 3 more years of residency training - High school students interested in becoming paediatricians should take basic science classes such as biology, chemistry, physics, algebra, geometry, and calculus - It is advisable for high school students to learn a foreign language, preferably Spanish in the United States - In medical school, student courses will focus on basic medical sciences like human anatomy, physiology, and chemistry - The training of paediatricians varies across the world and can take from 4 to 11 or more years depending on jurisdiction and specialization - In the United States, medical school graduates specializing in paediatrics must undergo a 3-year residency composed of outpatient, inpatient, and critical care rotations - Subspecialties within paediatrics require further training in the form of 3-year fellowships - Entry-level degrees are common to all branches of the medical profession in most jurisdictions - Junior medical doctors may need to undertake generalist training before specializing in paediatrics - Subspecialties within paediatrics include critical care, gastroenterology, neurology, infectious disease, hematology/oncology, rheumatology, pulmonology, child abuse, emergency medicine, endocrinology, neonatology, and others - paediatric subspecialties require additional training and expertise beyond general paediatrics - paediatric subspecialists focus on specific medical conditions and provide specialised care to children - Subspecialists work closely with general paediatricians to provide comprehensive care for paediatric patients - The availability of paediatric subs