Es ist nicht klar, wie groß die Rolle von Antibiotika https://antibiotika-wiki.de/ in den Wettbewerbsbeziehungen zwischen Mikroorganismen unter natürlichen Bedingungen ist. Zelman vaxman glaubte, dass diese Rolle minimal ist, Antibiotika werden nicht anders als in reinen Kulturen auf reichen Umgebungen gebildet. Anschließend wurde jedoch festgestellt, dass bei vielen Produzenten die Aktivität der antibiotikasynthese in Gegenwart anderer Arten oder spezifischer Produkte Ihres Stoffwechsels zunimmt.

Pediatric intake form

PEDIATRIC INTAKE FORM
Last name:________________________ First name and initial: ___________________ Parent(s)/Guardian(s): ____________________________________________________ Address: ___________________________________ City: __________________ Province: _________________ Postal Code: ____-____ Telephone: (___) ___-____ Date of birth: yyyy/mm/dd Height: _________________________ Weight: ____________________
Emergency contact: ________________________ Relationship: __________________
Emergency contact phone: (___) ___-____
Name of present MD: _________________________________Phone (___) ____-_____
Address of present MD: __________________________________________________
Chief complaints:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Date of onset: yyyy/mm/dd
Onset was: sudden / gradual / associated with an event: _________________________
Maternal Health and Birth History:
Term: premature / full / late
Location: hospital birthing centre home Delivery: vaginal / C-section / breech / forceps APGAR at birth: _____ APGAR at 5 minutes: _____ Birth weight: _____ Problems patient had at birth: breathing other:_______________________________________________ Was the infant alert and responsive within 12 hours of delivery? cord around neck respiratory depression other: ________________________________________________________________ Item(s) applied to patient at birth: medication other: ________________________________________________________________ Maternal condition: # pregnancies: _____ maternal age at patient’s birth: _____ paternal age at conception: _______ Maternal complications: hypertension other: ________________________________________________________________ Maternal health during pregnancy: STDs (herpes/chlamydia/syphilis/trichomonas) Exercise habits during pregnancy: __________________________________________
Stresses during pregnancy (physical/emotional): _______________________________
______________________________________________________________________
Cravings during pregnancy: ________________________________________________
Maternal medications during pregnancy:
Prescription: ____________________________________________________________
Over the counter: ________________________________________________________
Nutritional supplements: __________________________________________________
Childhood Medical Health of Patient:
Past Childhood Illnesses:
asthma
thrush (fungal infection in the mouth from a Candida infection)
Vaccination:
hepatitis B
varivax (chicken pox vaccine)
Any reactions to the vaccines, and if so, what kind? _____________________________
______________________________________________________________________
Growth and development:
At what age did the patient:
respond to sound _______________________ follow on object ___________________
hold head up __________________________ vocalize _________________________
sit alone ______________________________ teethe __________________________
crawl _________________________________ walk ___________________________
Do sleeping patterns seem normal to you? Y / N
Explain: _______________________________________________________________
Feeding History:
Was baby breast fed? Y / N
Introduction of cow’s milk at age ______ Type of solid foods introduced ______________________________________________ Age and type of commercial baby food introduced ______________________________ Any intolerances? Y / N explain: ________________________________________ Any cravings? __________________________________________________________ Is the child a picky eater? Y / N explain: __________________________________
Childhood Drug History:
Any antibiotics? Y / N
total number of courses of antibiotics: ________________ Other medications? Y / N 1-Medication: ______________ for: _____________________________________ Length of time on drug:___________________________________________________ Reactions to drug? ______________________________________________________ 2-Medication: ______________ for: _____________________________________ Length of time on drug:___________________________________________________
Reactions to drug? ______________________________________________________
Supplements: _________________________________________________________
Past hospitalizations: ____________________________________________________
_____________________________________________________________________
Past surgeries: _________________________________________________________
_____________________________________________________________________
Family Medical History:
Please indicate by noting M (mother), F (father), S (sibling), PGM (paternal
grandmother), MGM (maternal grandmother), PGF (paternal grand father), MGF
(maternal grandfather)
Allergy, asthma or eczema _________
Other: _________________________________________________________
Social influences and behaviours:
Who lives at home? _____________________________________________________
Any pets? Y / N
If yes, what? _________________ How long? _____________ If yes, who? ______________________________ Any behavioural problems? Y / N Onset: ___________________________________ Any night terrors, sleep walking, difficulty sleeping? Y / N Explain: _______________________________________________________________ Age of child when began daycare: __________________________________________ Average number of hours of television/computer/video games per week: ____________ Any difficulty with social interaction? Y / N explain: ___________________________ Extra-curricular activites / hobbies: __________________________________________ Exercise habits: _________________________________________________________ Do the parent(s) / guardian(s) work? Y / N Who? _____________________________ How many hours a week? _____ Number of hours spent with child per week _____ How old is the home? _________ How is it heated? __________________________ Any recent home renovations? _____________________________________________ How long have you been in the present home? ________________________________ Is it located near: trees other: _________________________________________________
General Review of Systems:
Does your child have any rashes, lumps, sores, itching, dry skin, change in hair or nails?
Y / N If yes: ___________________________________________________________________________
Has your child ever been unconscious, had a convulsion, have recurring headaches or
had a head injury?
Y / N If yes: ___________________________________________________________________________
Any problems with hearing, ringing in the ears, dizziness, ear infections, discharge?
Y / N If yes: ___________________________________________________________________________
Any problems with teeth, gums, tongue, sore throats or hoarseness?
Y / N If yes: ___________________________________________________________________________
Any problem with their eyes, including vision?
Y / N If yes: ___________________________________________________________________________
Has your child ever been cyanotic (turned blue), have a cough, wheeze, or asthma?
Y / N If yes: ___________________________________________________________________________
Any recurring problem with vomiting, diarrhea, constipation or stomach pain?
Y / N If yes: ___________________________________________________________________________
Any unusual problem on passing urine or any unusual frequency? Any unusual smell or
appearance to the urine?
Y / N If yes: ___________________________________________________________________________
Does your child complain of any extremity or lower back pain? Y / N
Do you notice a limp, or unusual gait pattern?
Y / N If yes: ___________________________________________________________________________
Has your child ever had blackouts, seizures, weakness, paralysis, numbness or loss of
sensation, tremors, or other involuntary movements?
Y / N If yes: ___________________________________________________________________________
Does your child have any thyroid trouble, excessive thirst or hunger, heat or cold
intolerance, or diabetes?
Y / N If yes: ___________________________________________________________________________
Any allergies, eczema, hay fever, hives or drug reactions?
Y / N If yes: ___________________________________________________________________________
Does you child have any intense fears, mood swings, or other sensitivities?
Y / N If yes: ___________________________________________________________________________
OTHER HEALTH CONCERNS & ADDITIONAL INFORMATION:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Source: http://www.pathtowellness.ca/assets/forms/Pediatric%20Intake%20Form.pdf