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Pediatric Annals

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https://www.readbyqxmd.com/read/28806468/an-overview-of-hemophagocytic-lymphohistiocytosis
#1
Ysabella M Esteban, Jill L O de Jong, Melissa S Tesher
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome characterized by a dysregulated hyperinflammatory response associated with aberrant activation of lymphocytes and macrophages that results in hypercytokinemia. It is classically divided into two types: (1) primary or familial HLH and (2) secondary HLH. Familial HLH is generally an autosomal recessive condition, whereas secondary HLH is usually associated with infectious diseases, autoinflammatory and autoimmune diseases (where it is more commonly known as macrophage activation syndrome), malignancy, immunosuppression, hematopoietic stem cell transplantation, organ transplantation, HIV infection, and metabolic diseases...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806467/the-history-of-home-cardiorespiratory-monitoring
#2
Gary E Freed, Francis Martinez
Home cardiorespiratory monitoring has changed significantly since it was first introduced in the 1970s. It has improved from a simple alarm system to a sophisticated piece of equipment capable of monitoring the patient's electrocardiogram, respiratory effort, and oxygen saturations. In addition, the indications for using a monitor have also changed. The home monitor was initially used to reduce the incidence of sudden infant death syndrome (SIDS). Although there were several studies demonstrating the reduction of SIDS rates in communities where apnea programs existed, none was a prospective, double-blinded study or had adequate numbers to be clinically significant...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806466/medicolegal-death-investigation-of-sudden-unexpected-infant-deaths
#3
Roger A Mitchell, Constance DiAngelo, Daniel Morgan
This review article describes the role of the medicolegal death investigator and medical examiner or coroner (MEC) in the investigations of a sudden unexpected infant death (SUID) beginning with an introduction into the case types that should be investigated and how infant deaths fit into that legal framework. The article also provides an overview of the history of the Centers for Disease Control and Prevention SUID investigation guidelines and process. The article concludes with a description of how the MEC correlates the scene investigation with autopsy findings, as well as the role of the MEC in cause of death determinations...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806465/safe-infant-sleep-practices-parental-engagement-education-and-behavior-change
#4
Sunah S Hwang, Michael J Corwin
Although the incidence of sudden unexpected infant death declined by nearly 50% in the 1990s, there has been little improvement in the past 15 years. Significant disparities in infant sleep practices and sleep-associated death exist, particularly by maternal race/ethnicity. This article provides a brief overview of recent observational and intervention studies related to infant sleep practices to describe the context and motivation for the population-based Study of Attitudes and Factors Effecting Infant Care (SAFE)...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806464/beyond-back-to-sleep-ways-to-further-reduce-the-risk-of-sudden-infant-death-syndrome
#5
Fern R Hauck, Kawai O Tanabe
Sudden infant death syndrome (SIDS) remains the leading cause of postneonatal mortality in the United States, despite reduction in rates of more than 50% since the initiation of the "Back to Sleep" (now called "Safe to Sleep") campaign in 1994. In recent years, the rate of decline in SIDS deaths has plateaued, even with the ongoing educational efforts that promote safe sleep and other risk reduction measures. The 2016 American Academy of Pediatrics guidelines for reducing the risk of SIDS focus heavily on sleep practices, bedding, and location, but also include factors that often receive less attention (ie, prenatal care, maternal smoking, alcohol and drug use, and childhood vaccinations)...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806463/the-evolving-understanding-of-sudden-unexpected-infant-death
#6
Christine G McIntosh, Edwin A Mitchell
Sudden unexpected infant death (SUID) is the leading cause for post-neonatal mortality in industrialized nations. Case-control studies have identified risk factors for SUID that have shaped research into studies of causation. Most current hypotheses for the mechanisms for SUID contribute to the "SUID sequence"-hypoxia and/or hypercarbia in sleep to which a vulnerable infant fails to respond adequately and that results in death. Reducing vulnerability in infants and promoting safe sleep for infants is important for prevention and requires knowledge of the prevalence of risk factors within the target population and a culturally sensitive approach...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806462/sudden-unexpected-infant-deaths-what-are-we-learning-and-how-can-we-reduce-the-risks
#7
EDITORIAL
Larry Consenstein
No abstract text is available yet for this article.
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806461/talking-to-adolescents-about-social-media
#8
Rachel S Dawson
I see a large number of adolescents in my clinic with issues related to their social media use. These issues range from lack of sleep, to depression, to cyberbullying, and even sex trafficking, all secondary to constant social media exposure. Pediatricians should ask about social media use when they see children and adolescents who already have access to electronic devices. They should also ask parents about controls that are set in place to monitor social media use, content, and friend connections on those sites...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28806460/sids-or-suid-the-emphasis-on-risk-reduction
#9
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697270/lucy-maude-montgomery-and-anne-of-green-gables-an-early-description-of-attention-deficit-hyperactivity-disorder
#10
Jessica Katz Edison, Christopher Clardy
Attention-deficit/hyperactivity disorder (ADHD) was added to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised in 1987. Similar disorders had appeared earlier, and many consider the first description of ADHD to be a lecture in 1902 about children with an "abnormal defect in moral control" but normal intelligence. This definition of ADHD is more alarming than the current one. Anne Shirley, the protagonist of the novel Anne of Green Gables (written by Lucy Maude Montgomery and published in 1908), shares the hyperactive and inattentive qualities that fit the current definition of ADHD...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697269/pediatric-cellulitis-a-red-hot-concern
#11
Andrew Shriner, Laurie Wilkie
Cellulitis and other skin and soft tissue infections are a common reason for children to seek care, both in the primary care setting and the emergency department. Cellulitis is a common skin and soft-tissue infection that is usually caused by streptococci bacteria or, less commonly, Staphylococcus aureus. Most children recover quickly from cellulitis, but a small subset will require hospitalization. Practitioners need to be skilled in the diagnosis and treatment of cellulitis, including recognition of the need for inpatient treatment...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697268/the-cost-of-hospital-admission-brief-resolved-unexplained-events
#12
Justin Triemstra
The modern health care system continues to expand at a meteoric rate with ever-increasing technological advancements. However, with these advancements come unsustainably rising costs and occasionally unintended, avoidable harm. In this article, we use a brief resolved unexplained event (BRUE) to illustrate how recent guidelines can help physicians practice value in this modern health care system. A BRUE is a common pediatric problem that is seen in ambulatory and emergency department settings. Infants presenting with a BRUE can be separated into low- and high-risk groups per recent guidelines...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697267/back-to-the-basics-community-acquired-pneumonia-in-children
#13
Kathleen Boyd
Community-acquired pneumonia (CAP) is a common childhood infection and often a reason for inpatient admission, especially when a child is hypoxic or in respiratory distress. Despite advances in technology and diagnostics, it remains difficult to accurately differentiate bacterial CAP from a viral process. Most of the laboratory tests routinely done in inpatient medicine, such as complete blood counts and acute phase reactants, do little to differentiate a viral pneumonia from a bacterial pneumonia. Clinicians must rely heavily on the clinical presentation and decide whether to treat empirically with antibiotics...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697266/less-is-more-evidence-based-management-of-bronchiolitis
#14
Elisa Hampton, Erika Abramson
Bronchiolitis is a common cause of outpatient visits and hospitalization in children younger than age 2 years. Despite the frequency with which pediatricians manage this diagnosis, there is significant variability in care in both the inpatient and outpatient setting. This may be due in part to changing guidelines set forth by leading pediatric organizations such as the American Academy of Pediatrics, as increasing evidence emerges that traditional therapies are not effective. This article reviews current evidence-based practices for diagnosis and treatment of bronchiolitis, and provides an overview of inpatient management...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697265/pediatric-hospital-medicine
#15
EDITORIAL
Laurie Wilkie
No abstract text is available yet for this article.
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697264/early-adversity-toxic-stress-and-resilience-pediatrics-for-today
#16
M Denise Dowd
Never before in the history of science have we had better insight into the factors that determine the health and well-being of a person from infancy to adulthood. An expanding body of knowledge is converging from numerous disciplines including neuroscience, education, behavioral science, public health, the social sciences, and medicine. Awareness of the impact of early childhood adversity and toxic stress is growing rapidly among both professionals and the lay public. This calls for a reevaluation of how and what we, as child health care providers, should deliver to maximize our impact on individual health and well-being across the lifespan...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28697263/community-primary-provider-involvement-in-hospital-care
#17
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28599030/pediatric-nephrolithiasis-a-review
#18
Tayaba Miah, Deepak Kamat
The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. Computed tomography (CT) is the gold standard for diagnosis; however, because of radiation exposure associated with a CT scan, ultrasonography is also an accepted modality for the diagnosis. Extensive metabolic evaluation is important to rule out an underlying metabolic disorder...
June 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28599029/transition-consultation-models-in-two-academic-medical-centers
#19
Jessica I Gold, Rebecca Boudos, Parag Shah, Rita Rossi-Foulkes
Health care transition (HCT), the organized progression from pediatric- to adult-focused models of care, is crucial for patients with chronic childhood conditions. More adolescents with chronic conditions now survive into adulthood and have increased risk of adverse events during HCT. Got Transition-an agreement between the Maternal and Child Health Bureau and the National Alliance to Advance Adolescent Health-developed the Six Core Elements of Health Care Transition 2.0, defining the components of HCT. Most HCT programs incorporate these elements, but delivery varies...
June 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28599028/transitioning-the-allergy-immunology-patient-from-childhood-to-adulthood
#20
Flavia C L Hoyte
Allergic disorders and immunodeficiencies are generally chronic and even lifelong conditions, often changing over time, making the cautious transition of care from childhood to adulthood particularly important. Many, but not all, patients can continue to receive their care from the same physician as they transition through adolescence and emerging adulthood, made possible because allergy/immunology training programs require cross-training in the care of both pediatric and adult patients. Although keeping the same physician makes the transition easier for many allergy/immunology patients, even these patients face psychosocial issues unique to adolescents and emerging adults, including increased autonomy, risk-taking behavior, and medical self-management...
June 1, 2017: Pediatric Annals
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