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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Talocalcaneal coalition resection.

Journal of the Pediatric Orthopaedic Society of North America·2025
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Criteria for surgical decision-making in talocalcaneal tarsal coalitions.

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Calcaneonavicular coalition resection with fat graft.

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Defining and Differentiating Congenital Vertical Talus and Congenital Oblique Talus: It's Not Primarily About the Talus.

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Concerning Ellsworth et al.: "Talocalcaneal Tarsal Coalition Size: Evaluation and Reproducibility of Magnetic Resonance Imaging Measurements".

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Related Experiment Video

Updated: Apr 11, 2026

A Mouse Model of Ankle-Subtalar Complex Joint Instability
09:14

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Subtalar coalition in pediatrics.

Vincent S Mosca1

  • 1Pediatric Foot and Ankle Service, Seattle Children's Hospital, 4800 Sand Point Way, N.E, OA.9.120, Seattle, WA 98105, USA; Department of Orthopaedics and Sports Medicine, University of Washington School of Medicine, 4333 Brooklyn Ave, N.E, Seattle, WA 98105, USA.

Foot and Ankle Clinics
|June 5, 2015
PubMed
Summary
This summary is machine-generated.

Subtalar tarsal coalition, a common foot deformity, often requires surgery when nonoperative treatments fail. Surgical techniques depend on coalition characteristics and patient-specific factors for pain relief.

Keywords:
Calcaneal lengthening osteotomyCalcaneonavicular tarsal coalitionSubtalar tarsal coalitionTalocalcaneal tarsal coalitionTarsal coalition resection

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Area of Science:

  • Orthopedics
  • Genetics
  • Developmental Biology

Background:

  • Subtalar tarsal coalition is an autosomal dominant developmental malformation.
  • It affects 2-13% of the population, with common locations between the calcaneus-navicular and talus-calcaneus.
  • Pain from coalition often necessitates surgical intervention after failed conservative management.

Purpose of the Study:

  • To review the indications for surgical intervention in subtalar tarsal coalition.
  • To outline the factors influencing the choice of surgical technique.

Main Methods:

  • Review of existing literature on subtalar tarsal coalition.
  • Analysis of factors guiding surgical decision-making.

Main Results:

  • Surgical intervention is indicated for persistent pain unresponsive to nonoperative management.
  • Surgical technique selection is multifactorial, considering pain location, coalition size/histology, joint health, foot deformity, and heel cord function.

Conclusions:

  • Subtalar tarsal coalition management requires individualized surgical planning.
  • Optimal surgical outcomes depend on precise assessment of anatomical and functional parameters.