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Pediatric Clinics of North America

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https://www.readbyqxmd.com/read/28502449/pediatric-gastroenterology
#1
EDITORIAL
Steven J Czinn, Samra S Blanchard
No abstract text is available yet for this article.
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502448/the-remarkable-gastrointestinal-tract
#2
EDITORIAL
Bonita F Stanton
No abstract text is available yet for this article.
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502447/the-transition-of-the-gastrointestinal-patient-from-pediatric-to-adult-care
#3
REVIEW
Punyanganie S A de Silva, Laurie N Fishman
Transition is the long process of developing independent self-management skills whereas transfer is the actual move from pediatric to adult-centered provider. Structured anticipated transition works best with timelines of tasks to master and discussion of the stylistic differences between pediatric and adult practices. Disease-specific issues need to be addressed, such as earlier timelines for diet-based therapies, parental support for critical illnesses, and differences in therapeutic strategies.
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502446/pancreatic-disorders
#4
REVIEW
Aliye Uc, Douglas S Fishman
Once considered uncommon, pancreatic diseases are increasingly recognized in the pediatric age group. Acute pancreatitis, acute recurrent pancreatitis, and chronic pancreatitis occur in children with an incidence approaching that of adults. Risk factors are broad, prompting the need for a completely different diagnostic and therapeutic approach in children. Although cystic fibrosis remains the most common cause of exocrine pancreatic insufficiency, other causes such as chronic pancreatitis may be as common as Shwachman Diamond syndrome...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502445/pediatric-liver-transplantation
#5
REVIEW
Nidhi Rawal, Nada Yazigi
Excellent outcomes over the last 3 decades have made liver transplantation the treatment of choice for many advanced liver disorders. This success also opened liver transplantation to new indications such as liver tumors and metabolic disorders. The emergence of such new indications for liver transplantation is bringing a new stream of patients along with disease-specific challenges. The cumulative number of liver transplant recipients is peaking, requiring novel systems of health care delivery that meet the needs of this special patient population...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502444/nonalcoholic-fatty-liver-disease-in-children-hepatic-and-extrahepatic-complications
#6
REVIEW
Praveen Kumar Conjeevaram Selvakumar, Mohammad Nasser Kabbany, Valerio Nobili, Naim Alkhouri
Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome and has become the most common form of chronic liver disease in children and adolescents. The histologic spectrum of NAFLD is broad ranging, from the relatively benign form of simple steatosis to the aggressive form of nonalcoholic steatohepatitis, eventually leading to fibrosis and cirrhosis. NAFLD has also been recognized as an independent risk factor for extrahepatic complications, such as cardiovascular disease, type 2 diabetes mellitus, sleep disorders, and osteoporosis...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502443/hepatitis-b-and-c
#7
REVIEW
Wikrom Karnsakul, Kathleen B Schwarz
Chronic viral hepatitis is a global health threat and financial burden. Hepatitis B and C viruses (HBV and HCV) are the most common causes of chronic viral hepatitis in the United States. Most cases are asymptomatic before adulthood. Research has resulted in effective therapy for HCV and the promise of effective therapies for HBV. For HCV, therapy is pegylated interferon and ribavirin. Clinical trials with effective direct-acting antiviral agents are underway in pediatrics. For HBV, approved agents are alpha-interferon, lamivudine, adefovir, tenofovir, and entecavir...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502442/neonatal-cholestasis
#8
REVIEW
Erin Lane, Karen F Murray
Neonatal jaundice is common and usually not concerning when it is secondary to unconjugated hyperbilirubinemia, below the neurotoxic level, and resolves early. Primary care providers should be vigilant, however, about evaluating infants in whom jaundice presents early, is prolonged beyond 2 weeks of life, or presents at high levels. Even in well-appearing infants, fractionated (direct and indirect) bilirubin levels should be obtained in these clinical scenarios to evaluate for potential cholestasis. This review presents an approach to the evaluation of a jaundiced infant and discusses diagnosis and management of several causes of neonatal cholestasis...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502441/intestinal-transplant-in-children
#9
REVIEW
Nidhi Rawal, Nada Yazigi
The past decade has seen major advances in the field of transplantation; it is the treatment of choice for many with intestinal failure. One-year mortality from pediatric intestinal transplantation has significantly declined, from 30% to 10% to 15% nationally, mainly due to a multidisciplinary approach in transplant centers. Pediatric age carries special considerations along the spectrum of care that continue to cause challenges but also offers growth opportunities. Pediatric intestinal transplantation indications and timing are changing as a result of new developments in diagnostic and treatment tools...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502440/motility-disorders-in-children
#10
REVIEW
Samuel Nurko
Gastrointestinal motility disorders in the pediatric population are common and can range from benign processes to more serious disorders. Performing and interpreting motility evaluations in children present unique challenges. There are primary motility disorders but abnormal motility may be secondary due to other disease processes. Diagnostic studies include radiographic scintigraphic and manometry studies. Although recent advances in the genetics, biology, and technical aspects are having an important impact and have allowed for a better understanding of the pathophysiology and therapy for gastrointestinal motility disorders in children, further research is needed to be done to have better understanding of the pathophysiology and for better therapies...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502439/pediatric-inflammatory-bowel-disease
#11
REVIEW
Máire A Conrad, Joel R Rosh
Inflammatory bowel disease (IBD), including Crohn disease, ulcerative colitis, and IBD-unspecified, is a chronic immune-mediated condition of the gastrointestinal tract in which the goal of treatment is to induce and maintain durable remission. In pediatrics, there is a wide spectrum of presenting symptoms, but esophagogastroduodenoscopy and colonoscopy are imperative to confirming the diagnosis. Treatment goals include achieving mucosal healing of the gastrointestinal tract, reaching growth potential, limiting medication toxicities, and optimizing quality of life for all patients...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502438/celiac-disease-and-nonceliac-gluten-sensitivity
#12
REVIEW
Runa D Watkins, Shamila Zawahir
Gluten-related disorders include celiac disease (CD), wheat allergy, and nonceliac gluten sensitivity. CD is an autoimmune enteropathy caused by damage to small intestinal mucosa when gluten is ingested in genetically susceptible individuals. Currently, the only available treatment of CD is gluten-free diet. Several potential treatments are being researched. Wheat allergy is a hypersensitivity reaction caused by IgE-mediated and/or non-IgE-mediated immune response, and can involve the gastrointestinal tract, skin, or respiratory tract...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502437/gastrointestinal-bleeding-and-management
#13
REVIEW
Anita K Pai, Victor L Fox
There is a broad clinical spectrum of gastrointestinal bleeding in children, ranging from subtle laboratory findings to dramatic clinical presentations. This review provides a framework for the evaluation and management of gastrointestinal hemorrhage for pediatricians. It outlines strategies for obtaining a tailored patient history and conducting a thorough physical examination that can shed light on the location, severity, and likely etiology of bleeding. It appraises blood tests, radiologic tools, and endoscopic modalities frequently used to identify and control a source of bleeding...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502436/abdominal-pain-in-children-from-the-eternal-city-to-the-examination-room
#14
REVIEW
Donna K Zeiter
Abdominal pain is a common presenting symptom in children. The differential diagnosis of abdominal pain is extensive; however, a vast majority of patients ultimately are diagnosed with functional abdominal pain disorders. Functional gastrointestinal disorders are defined using the recently released Rome IV criteria. These are not diagnoses of exclusion. If there are no alarm signs, the diagnosis may be made with a focused evaluation. Treatment of these disorders requires a biopsychosocial approach to the disorder and an individualized and multipronged treatment plan...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502435/caustic-ingestions-and-foreign-bodies-ingestions-in-pediatric-patients
#15
REVIEW
Jacob A Kurowski, Marsha Kay
Children inevitably swallow foreign material accidentally or intentionally. Each type of ingestion carries their own set of risks and complications, short and long term, some requiring immediate attention while others close monitoring. Alkalotic household cleaning products and lithium button batteries are increasingly common and damage the esophagus quickly. While many toys with rare-earth metals are banned, they are already present in many households and can cause necrosis of bowel that is between the magnets...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502434/gastroesophageal-reflux-disease
#16
REVIEW
Hayat Mousa, Maheen Hassan
Gastroesophageal reflux (GER) is a normal physiologic process. It is important to distinguish GER from GER disease (GERD) since GER does not require treatment. Although a diagnosis of GERD can largely be based on history and physical alone, endoscopy and pH impedance studies can help make the diagnosis when there in atypical presentation. In children and adolescents, lifestyle changes and acid suppression are first-line treatments for GERD. In infants, acid suppression is not effective, but a trial of hydrolyzed formula can be considered, as milk protein sensitivity can be difficult to differentiate from GER symptoms...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28502433/eosinophilic-gastrointestinal-disorders
#17
REVIEW
Lisa M Fahey, Chris A Liacouras
Eosinophilic esophagitis (EoE) is an atopic disease that is characterized by an isolated infiltration of eosinophils into the epithelium of the esophagus and is triggered by specific allergens. Patients should undergo an upper endoscopy with biopsy after 6 to 8 weeks of treatment with a proton pump inhibitor in order to make the diagnosis of EoE. Eosinophilic gastroenteritis is a pathologic eosinophilic infiltration of any portion of the gastrointestinal tract, and eosinophilic proctocolitis is an eosinophilic infiltration in the colon alone...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28292460/a-primer-for-primary-care-clinicians-caring-for-sexually-active-adolescents
#18
EDITORIAL
Marianne E Felice
No abstract text is available yet for this article.
April 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28292459/adolescents-too-are-not-just-little-adults
#19
EDITORIAL
Bonita F Stanton
No abstract text is available yet for this article.
April 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28292458/treating-youths-in-the-juvenile-justice-system
#20
REVIEW
Ann L Sattler
Adolescents involved with the juvenile justice system have higher rates of risky sexual behaviors, resulting in high rates of sexually transmitted infections and increased risk of human immunodeficiency virus, early or complicated pregnancy, and parenting issues. Comorbid substance abuse, gang association, mental health issues, and history of having been abused as children result in further elevated rates. Girls and lesbian, gay, bisexual, and transgender youths represent growing subpopulations with special risks...
April 2017: Pediatric Clinics of North America
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