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Pediatric Annals

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https://www.readbyqxmd.com/read/28192583/erratum-for-emergency-department-triage-of-the-incessantly-crying-baby
#1
(no author information available yet)
No abstract text is available yet for this article.
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192582/use-of-electronic-nicotine-delivery-systems-among-adolescents-status-of-the-evidence-and-public-health-recommendations
#2
Aarti D Kamat, Alison L Van Dyke
Although the prevalence of tobacco smoking has been declining in recent years, the use of electronic nicotine delivery systems (ENDS) such as of electronic cigarettes, vaporizers, and hookahs has been steadily rising, especially among adolescents. ENDS are not only advertised to children, but their sale via the Internet has made them easily accessible to youth. In general, children perceive ENDS as safe, or at least safer than smoking traditional combustible tobacco products; however, exposure to nicotine may have deleterious effects on the developing brain...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192581/necrotizing-pneumonia
#3
Elitsa V Nicolaou, Allison H Bartlett
Necrotizing pneumonia refers to the development of necrosis, liquefication, and cavitation of the lung parenchyma from an infectious pathogen. Nearly 4% of all community-acquired pneumonias are necrotizing, although studies retrospectively evaluating the incidence have found it to be increasing during the past 20 years. Common presenting symptoms include fever, tachypnea, and cough, and most of those afflicted also develop complications such as parapneumonic effusions, empyemas, or bronchopleural fistulae. When compared to age-matched controls with parapneumonic effusions or severe pneumonias without a necrotizing component, those with necrotizing pneumonia have been shown to have more elevated white blood cell counts and inflammatory markers that take longer to normalize, a longer duration of symptoms despite initiation of therapy, and a longer hospital stay...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192580/a-brief-resolved-unexplained-event-and-congenital-neurosyphilis
#4
Justin Triemstra, Kelsey Reno, Rebecca Chohlas-Wood, Colleen Nash
Brief resolved unexplained event (BRUE) is a common pediatric problem that presents to ambulatory and emergency settings. Infants presenting with a BRUE can be separated into low- and high-risk groups per recent guidelines. Most low-risk infants who present with a BRUE can be discharged home with anticipatory guidance and education provided to the caregivers; however, high-risk infants should undergo further testing and observation to determine the cause of their event. Congenital neurosyphilis can be a rare cause of a BRUE...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192579/infectious-diseases-and-immunizations-in-international-adoption
#5
Emily Obringer, Linda Walsh
Children who are adopted internationally have an increased risk of infectious diseases due to endemic conditions and variable access to preventive health care, such as vaccines, in their country of origin. Pediatricians and other providers who care for children should be familiar with the recommended screening for newly arrived international adoptees. Testing for gastrointestinal pathogens, tuberculosis, hepatitis, syphilis, and HIV should be routinely performed. Other endemic diseases and common skin infections may need to be assessed...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192578/when-the-great-masquerader-reveals-itself-tuberculosis
#6
Brittany Hodgson, Benjamin D Kornfeld, Bridget M Wild
Pneumonia is a clinical diagnosis often treated empirically and successfully on an outpatient basis. When a patient fails to improve, the clinician is left to revisit the differential of pathogens and reconsider the host. Admission, imaging, and invasive and noninvasive testing are part of the toolkit for the severe or atypical case of pneumonia. For fastidious organisms, achieving a culture-proven diagnosis can be quite difficult. This article discusses the screening and testing for tuberculosis, reviews the utility of computed tomography imaging and bronchoscopy with bronchoalveolar lavage in severe or atypical pneumonia, and highlights the barriers to definitive diagnosis even when the causative microbe is on the differential diagnosis when a patient is admitted...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192577/diagnosing-acute-hiv-infection
#7
Paul Devine Bottone, Allison H Bartlett
Acute HIV infection (AHI) represents the first 6 to 12 weeks of the disease process, when the virus is aggressively replicating in the lymphoid tissues. Accordingly, high viral loads are often present during this phase, with declining lymphocyte levels, as the CD4+ T-cell subset is preferentially commandeered to facilitate viral reproduction. Detection at this stage is imperative-the affected are often unaware, but highly infectious. Unfortunately, correct diagnosis of AHI can be challenging because the more traditional, frequently used tests, which rely on antibody detection, will often produce false-negative results during the "window period" (usually 3 to 4 weeks from infection) due to slow production of HIV antibodies...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192576/herpes-simplex-virus-in-the-neonate
#8
Amy Wang, Julie Wohrley, Julia Rosebush
Neonatal herpes simplex virus (HSV) disease is a serious, life-threatening condition that should be considered in neonates with fever, vesicular rash, culture negative sepsis, and/or seizure activity. Because signs and symptoms of neonatal HSV may closely resemble those of bacterial sepsis, a thorough history and appropriate testing are imperative to accurately confirm the diagnosis. Failure to treat vesicular lesions from HSV in the neonate leads to an approximate 75% chance of progression to disseminated disease and/or meningoencephalitis...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192575/less-common-pediatric-infectious-diseases-revisited
#9
EDITORIAL
Julia Rosebush, Ram Yogev
No abstract text is available yet for this article.
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192574/primary-care-asthma-management-inhaled-corticosteroids-and-other-clinical-pearls
#10
Zachary Marcus, Nanah Suk Park
Most children in the United States with intermittent, mild, and moderate persistent asthma are cared for by primary care practitioners (PCPs). Despite inhaled corticosteroids (ICS) being highly effective at controlling asthma symptoms, many PCPs are uncomfortable prescribing these medications. Cumbersome guidelines, increasing numbers of medication choices, and concerns regarding side effects are some of the barriers to prescribing ICS for children with asthma. This article serves as a quick-start guide for PCPs that (1) condenses the routine diagnosis and management of asthma into concise clinical tools for children who would benefit from ICS therapy and (2) provides clinical pearls to aid in the treatment of mild- to moderate-persistent asthma...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28192573/uncommon-infectious-disease-presentations-and-a-reminder-that-quality-improvement-is-meant-to-improve-care
#11
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079916/adolescent-shin-pain
#12
Jeremy Korsh, Douglas Matijakovich, Charles Gatt
Shin pain is a common complaint in adolescent athletes. The term "shin splints" has historically been applied to these patients. Shin splints, more often than not, refers to a stress reaction of the tibia from overuse. Overuse injuries occur when repetitive microtrauma to the bone exceeds the biologic healing potential. Diagnosis is based on typical history and physical examination findings. Plain radiographs and advanced imaging are rarely necessary but can provide valuable prognostic information. Treatment consists of adequate rest and exercise modification...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079915/intravenous-immunoglobulin-for-the-treatment-of-kawasaki-disease
#13
Stanford T Shulman
Standard first-line therapy for Kawasaki disease (KD) consists of intravenous immunoglobulin (IVIG) and aspirin. Current guidelines recommend 2 g/kg of IVIG and 80 to 100 mg/kg of aspirin administered within the first 10 days of illness. This regimen has marked efficacy in preventing the development of coronary artery aneurysms. Approximately 15% to 20% of treated patients require a second dose of IVIG to control the inflammatory process. The role of adjunctive corticosteroid therapy with IVIG and aspirin is evolving, with Japanese studies showing a clear benefit in those patients at highest risk for development of coronary disease...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079914/intravenous-immunoglobulin-in-pediatric-rheumatology-when-to-use-it-and-what-is-the-evidence
#14
Martha M Rodriguez, Linda Wagner-Weiner
Intravenous immunoglobulin (IVIG) is given to children with a variety of rheumatologic illnesses. The mechanism of action by which it exerts therapeutic effects is not well understood and likely differs in the medical conditions for which it is given. IVIG is approved by the US Food and Drug Administration and is the standard of care for Kawasaki disease, but most IVIG use in pediatric rheumatology is "off-label. " The literature supports the use of IVIG for juvenile dermatomyositis, although it is unclear whether its use should be limited to those children with more severe or refractory disease...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079913/intravenous-immunoglobulin-in-the-treatment-of-hematologic-disorders-in-pediatrics
#15
Gabriela Villanueva, Jill L O de Jong, Jennifer L McNeer
Intravenous immunoglobulin (IVIG) is pooled immunoglobulin G derived from human blood donors. It was introduced in the early 1980s to treat immunodeficiency disorders. Since then, its use has expanded to other fields such as neurology, rheumatology, and hematology. IVIG has been used to provide passive immunity in qualitative and quantitative immunoglobulin disorders, to neutralize antibodies in immune-mediated diseases, and as an immune modulatory agent. The difficulty of producing IVIG in high quantities, in addition to a growing list of "off-label" indications, has resulted in a worldwide shortage and increase in cost...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079912/intravenous-immunoglobulin-in-the-treatment-of-primary-immunodeficiency-diseases
#16
Deirdre De Ranieri, Nana Sarkoah Fenny
Intravenous immunoglobulin (IVIG) has been used as antibody replacement therapy in primary immunodeficiency diseases (PIDDs) for more than 50 years. Its role as a therapeutic agent has expanded over the past couple of decades as its anti-inflammatory and immune-modulatory mechanisms of action have been elucidated. It is now used "off-label" to treat other autoimmune diseases. This article focuses on the role of IVIG in the treatment of PIDDs characterized by absent or deficient antibody production. Replacement doses are given on a monthly basis in these conditions as a prophylactic measure to prevent acute and serious bacterial infections...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079911/intravenous-immunoglobulin-and-its-clinical-applications
#17
EDITORIAL
Deirdre De Ranieri
No abstract text is available yet for this article.
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079910/human-papillomavirus-and-the-hpv-vaccine-where-are-we-today
#18
Leah Khan
Vaccine discussions are an important part of the general pediatrician's day. The human papillomavirus (HPV) vaccine, in particular, has been slow to gain acceptance by the general public. It has recently gained momentum (both positive and negative) on social media, which has led to an increase in questions and concerns from families. It is important that providers are equipped to address these concerns, answer questions, and provide quality information for families to help guide them in their vaccination decisions...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28079909/the-clinical-utility-of-intravenous-immunoglobulin-and-when-to-involve-our-consultants
#19
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/27975114/the-ketogenic-diet-a-practical-guide-for-pediatricians
#20
Aimee F Luat, Leigh Coyle, Deepak Kamat
The ketogenic diet is an effective treatment for drug-resistant epilepsies in children. In addition, it is the first-line treatment for some metabolic disorders, such as glucose transporter 1 deficiency syndrome. This article discusses the proposed mechanisms of a ketogenic diet's antiseizure action, its clinical indications, and its contraindications. The steps involved in ketogenic diet initiation, monitoring, and management of its side effects are also discussed. This review provides general pediatricians with the necessary skills to provide comprehensive care of children using the ketogenic diet and counsel their families and caregivers...
December 1, 2016: Pediatric Annals
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