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Pediatric Annals

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https://www.readbyqxmd.com/read/28079916/adolescent-shin-pain
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27975113/pediatric-liver-transplantation-an-update-for-the-pediatrician
#10
Kristin Capone, Karine Amirikian, Ruba K Azzam
Pediatric liver transplantation is a state-of-the-art treatment for children with end-stage liver disease. Over the past few decades, the advent of new surgical techniques using split liver grafts and living donors has drastically increased the organ availability for pediatric patients, while advances in immunosuppression have improved overall outcomes. The pediatrician is a key player in the multidisciplinary team that cares for these children starting with the timely referral of children who require liver transplantation to the active participation in optimizing the child's overall health before and after transplantation...
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27975112/acute-liver-failure
#11
Catherine D Newland
Pediatric acute liver failure (ALF) is a complex and rapidly progressive syndrome that results from a variety of age-dependent etiologies. It is defined by the acute onset of liver disease with no evidence of chronic liver disease. There must be biochemical or clinical evidence of severe liver dysfunction as defined by an international normalized ratio (INR) ≥2. If hepatic encephalopathy is present, INR should be ≥1.5. Unfortunately, due to the rarity of ALF in pediatric patients, there is a paucity of diagnostic and management algorithms and each patient must have an individualized approach...
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27975111/an-overview-of-cirrhosis-in-children
#12
Jonathan Cordova, Hilary Jericho, Ruba K Azzam
Cirrhosis is the end result of nearly all forms of progressive liver disease. The diffuse hepatic process can be characterized as a state of inflammation progressing to fibrosis and resulting in nodular regeneration, ultimately leading to disorganized liver architecture and function. The underlying etiology of cirrhosis in children may often differ from adults owing to specific disease processes that manifest in childhood, including biliary atresia, galactosemia, and neonatal hepatitis. Although basic management strategies in children are similar to those in adults, the care given to children with cirrhosis must keep the child's growth and development of paramount importance...
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27975110/viral-hepatitis-in-children-a-through-e
#13
Ankur Chugh, Maryann Maximos, Meryl Perlman, Regino P Gonzalez-Peralta
Hepatitis is defined as inflammation of the liver. This inflammation can be acute and self-limited, chronic (leading to cirrhosis and an increased risk for hepatocellular carcinoma), or fulminant (requiring lifesaving liver transplantation). Although there are many causes of hepatitis, this article focuses on the main childhood viral hepatidities: types A, B, C, D, and E. This review discusses the main characteristics of each virus, including salient epidemiology, clinical characteristics, diagnosis, treatment, and prevention strategies...
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27975109/cholestasis-in-infancy
#14
Melissa G Andrianov, Ruba K Azzam
Jaundice is a key manifestation of hepatobiliary disease in all age groups. Jaundice is a common finding in the first 2 weeks after birth, occurring in 2.4% to 15% of newborns. The neonatal liver is at increased susceptibility to cholestasis, with an incidence ranging from 1 in 2,500 to 1 in 5,000 live births. Etiologies vary, but the most common is biliary atresia. In 2004, the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition published guidelines for the evaluation of cholestasis that clearly stated any infant with jaundice persisting beyond age 2 weeks (3 weeks in breast-fed infants with an otherwise normal history and physical examination) should be evaluated with a fractionated serum bilirubin level...
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27975108/pediatric-hepatology
#15
EDITORIAL
Ruba K Azzam
No abstract text is available yet for this article.
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27975107/pediatricians-as-psychiatrists
#16
Edward S Traisman
The overall health of children and teenagers is dependent on their physical and psychological health. As pediatricians, it is important to enquire about the mental health of children and adolescents at the well-child visit. Screening for depression and attention-deficit/hyperactivity disorder is an important component of that visit. Understanding these disorders and the long-term effects on both the child and family as well as managing psychotherapeutic and pharmacological treatments are now becoming a critical part of pediatric care for children and adolescents...
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27975106/aspects-of-pediatric-hepatology-and-access-to-pediatric-health-care
#17
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841924/pectus-excavatum-more-than-a-matter-of-aesthetics
#18
Fizan Abdullah, Jamie Harris
Pectus excavatum (PE) is the most common congenital chest abnormality, and affects males 5 times more frequently than females. PE results from improper fusion of the ribs with the sternum during embryologic development. The cardinal presenting sign is chest depression. Evaluation includes serial measurement of the chest deformity defect. Additional evaluation of cardiopulmonary function, including arrhythmias and pulmonary function tests, should be done as well. Computed tomography scans are used to determine the Haller index, a measure of deformity severity, with a measurement of greater than 3...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841923/urticaria-you-re-probably-just-allergic-to-something
#19
Jordan Smallwood
Urticaria is a common symptom seen in pediatric patients, and it has multiple allergic and nonallergic causes. Unfortunately, it is far too common that when children present acutely for urticaria, they are told that it is an "allergy." This statement often leads to increased anxiety while the patient waits to be evaluated by an allergist/immunologist. This article discusses the frequency that allergic reactions are involved in urticaria and provides examples of potential nonallergic causes. Additionally, the article discusses approaches to treatment that may be appropriate to initiate in the pediatrician's office or acute setting...
November 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27841922/emergency-department-triage-of-the-incessantly-crying-baby
#20
Caroline Chua, Jennifer Setlik, Victoria Niklas
Incessant crying is one of the most common caregiver complaints during emergency department (ED) visits in the first few months of the child's life. Although the majority of cases are attributed to normal infant behavior, the differential diagnosis remains broad. Moreover, the potential for the negative impact of incessant crying on the mental well-being of caregivers as well as the infants necessitates that complaints be taken seriously and that "red flags" for underlying organic causes be ruled out and caregiver anxiety quelled...
November 1, 2016: Pediatric Annals
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